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Test Information
Test Name
Total Questions
300
Test Type
Examination
Difficulty Level
Difficult
Total Marks
1500
Duration
180minutes
A bacterial culture with a starting density of 103cells/ml is incubated in liquid nutrient broth. If the bacteria have both a lag time &
generation time of 10 minutes, what will the cell density be at 30 minutes
a. 1.0 x 103
b. 2.0 x 103
c. 3.0 x 103
d. 4.0 x 103
Solution. (d) 4.0 x 103
Ref:Read the text below
Sol :
Therefore after lag phase of 10 minutes two divisions will be possible in the next 20 minutes.
Your Answer. b
Correct Answer. d
(2).
2/119
(3).
Your Answer. a
Correct Answer. a
(4).
(5).
3/119
(6).
(7).
(8).
4/119
(9).
Delta hepatitis only occurs in patients who also have either acute or chronic infection with hepatitis B virus. The delta agent is :
a. An incomplete hepatitis B virus
b. Related to hepatitis A virus
c. A hepatitis B mutant
d. An incomplete RNA virus
Solution. (d) An incomplete RNA virus
Ref.:Read the text below
Sol :
The delta agent was first described in 1977 and has recently been shown to be an incomplete RNA virus that requires HBsAg for
replication.
It is found most often in persons who have multiple parenteral exposures (e.g. intravenous (IV) drug abusers, hemophiliacs, and
multiply transfused patients.
Your Answer. d
Correct Answer. d
(10).
Cell envelopes of both gram-positive and gram-negative bacteria are composed of complex macromolecules. Which of the
following statements describes both gram-positive and gram-negative cell envelops?
a. They contain significant amount of teichoic acid
b. They are diffusion barrier to large charged molecules
c. Their antigenic specificity is determined by the polysaccharide O antigen
d. They act as a barrier ot the extraction of crystal violet iodine by alcohol
Solution. (b) They are diffusion barrier to large charged molecules
Ref.:Read the text below
Sol :
Bacterial cell envelopesconsist of both the cell wall and cell membrane; in gram positive and gram negative bacteria, this
cytoplasmic membrane acts as a diffusion barrier to large charged molecules.
The cell envelope of gram negative bacteria contains lipoprotein, lipopolysaccharide, and peptidoglycan, molecules; the
polysaccharide component of the lipopolysaccharide is the O antigen, the chief surface antigen of these bacteria.
On the other hand, gram positive organisms contain large amounts of teichoic acids, which are important surface antigens for these
bacteria.
The cell wall of gram positive bacteria acts as a barrier to the extraction of crystal violet iodine complex by alcohol; this property
is the basis of the Grams stain.
Your Answer. b
Correct Answer. b
5/119
(11).
(12).
The 'safety pin' appearance is given by all except :a. Burkholderia mallei
b. Burkholderia pseudomallei
c. Yersinia
d. Calymmatobacterium
Solution. (a) Burkholderia mallei
Ref:Read the text below
Sol :
Yersinia show bipolar staining (safety pin appearance) with the two ends densely stained and the central area clear.
Calymmatobacterium show bipolar condensation of chromatin giving a closed 'safety pin appearance' in stained smears.
Your Answer. b
Correct Answer. a
(13).
6/119
(14).
Rose-Waller test is a type of passive hemagglutination test, which is used to detect RA factor in patients of rheumatoid arthritis.
Your Answer. b
Correct Answer. c
(15).
(16).
The lymphatic sheath immediately surrounding the central arteriole is the thymus dependent area of the spleen.
The perifollicular region, germinal center and mantle layer forms the bursa dependent areas.
Your Answer. b
Correct Answer. a
7/119
(17).
(18).
(19).
8/119
(20).
(21).
Local anaesthetic solutionsare deposited in the epidural space between the dura mater and the periosteum lining the vertebral
canal. The epidural space contains adipose tissue, lymphatics and blood vessels. The injected local anaesthetic solution produces
analgesia by blocking conduction at the intradural spinal nerve roots.
The quality and extent of the blockade produced by each agent is determined by the volume as well as the total dose of the drug. The
spread of local anaesthetic solutions may be more extensive ipregnant women as the volume of the potential space is reduced by venous
engorgement in the epidural space. Enhanced effects may also be seen in the elderly and in patients with arteriosclerosis due
to impairment of vascular absorption from the epidural space.
Bupivacaine (0.5%) or lignocaine (1.5-2.0%) are usually used to produce extradural anaesthesia. Repeated administration of
lignocaine or mepivacaine into the epidural space may result in a diminished response with each subsequent dose (tachyphylaxis). This
may be due to local changes in pH due to the relative acidity of these solutions. The reduction in pH may reduce the amount of
free base available for diffusion across the neuronal membrane
Your Answer. a
Correct Answer. a
(22).
9/119
(23).
(24).
Per kilogram of body weight, the highest dose requirement for thiopental at induction is in
a. The elderly
b. 30-to 50 year old adults
c. 6 to 12 months old infants
d. 1 to 6 month old infants
Solution. (d) 1 to 6 month old infants
Ref:Read the text below.
Sol:
The highest dose requirement for thiopental at induction is in 1- to 6-month-old infants.
The ED50 (the dose at which 50 percent of the children are induced) at this age was found to be close to 7 mg/kg.
In adults the induction dose range is 2.5 to 4.5 mg/kg, while in older children it is 5 to 6 mg/kg.
Your Answer. b
Correct Answer. d
(25).
Which of the following orders of speed of recovery and return of psychomotor function is correct?
a.
b
c.
d.
a. Propofol > midazolam > thiopental > methohexital
b. Propofol > thiopental > midazolam > methohexital
c. Propofol > midazolam > methohexital > thiopental
d. Propofol > methohexital > thiopental > midazolam
Solution. (d) Propofol > methohexital > thiopental > midazolam
Ref:Read the text below.
Sol:
Propofol has the most rapid recoveryof the four induction agents, irrespective of the maintenance agent.
Methohexitalhas a slightly faster recovery than thiopental.
Barbiturates have more rapid recovery than benzodiazepines such as midazolam.
Your Answer. c
Correct Answer. d
10/119
(26).
Which of the following drugs produce rapid induction of sleep with least influence on sleep architecture
a. Zaleplon
b. Diazepam
c. Chlorpromazine
d. Haloperidol
Solution. (a) Zaleplon
Ref.:Harrison-175
Sol :
Benzodiazepine-receptor agonists arethe most effective and well-tolerated class of medications for insomnia.
The broad range of half-lives allows flexibility in the duration of sedative action.
The most commonly prescribed agents in this family are :
Zaleplon (5-20 mg.) witha half-life of 1-2 h;
Zolpidem (5-10), and Triazolam(0, 125-0.25 mg), with half-lives of 2-3 h;
Eszopiclone (1-3 mg), with a half-life of 5.5-8 h; and
Temazepam (15-30 mg) and Lorazepam(0.5-2 mg), with half-lives of 6-12 h.
Your Answer. a
Correct Answer. a
(27).
Lidocaine belongs to derivatives of acetanilide, realizes local anesthetic and antiarrhythmic actions.
Is used for all kinds of local anesthesia: terminal, infiltration, conduction anesthesia. From mucous membranes it is soaked up
quickly enough and it can have a systemic effect.
Epinefrine is an adrenergic agonist, narrowingvessels and extending the action of lidocaine
Your Answer. b
Correct Answer. b
11/119
(28).
A Liver dysfunction may result in prolonged duration of action of anesthetic and neuromuscular blocking agents because of
altered metabolism or clearance rates. Isoflurane is the preferred anesthetic agent for patients with cirrhosis, while
methoxyflurane, chloroform and halothane should be avoided if possible.
In addition, the actions of neuromuscular blocking agents may be prolonged due to increased biliary excretion and decreased
pseudocholinesterase activity.
Therefore, atracurium is the drug of choice in patients with liver disease or biliary obstruction, and doxacurium is
recommended for prolonged surgeries. Oxazepam and lorazepam are the most suitable anxiolytic sedatives, whereas fentanyl and
sufentanyl should be the first-line narcotics.
In contrast, morphine, meperidine and barbiturates can precipitate hepatic encephalopathy and should be avoided llergic
reactions to procaine are usually not in response to procaine itself, but to PABA.
Your Answer. d
Correct Answer. c
(29).
Which one of the following when given IV can cause intense pain:
a. Thiopentone
b. Ketamine
c. Fentanyl
d. Midazolam
Solution. (a) Thiopentone
Ref Read the text below
Sol:
Thiopentone, when givenIV, if extravasated, produces intense pain. Also, inadvertent intrarterial injection causes severe pain,
necrosis and gangrene.
Your Answer. a
Correct Answer. a
12/119
(30).
(31).
The structures that passes between middle cerebellar peduncle and pons is :
a. Trigeminal nerve
b. Vagus nerve
c. Olfactory nerve
d. Optic nerve
Solution. (a) Trigeminal nerve
Ref: Read the text below
Sol :
The pons is dominated by the massive, transversely oriented structure on its ventral surface.
This part of the pons is called the basal pons and looks like a bridge interconnecting the two cerebellar hemispheres.
It does not, however, interconnect them.
Rather, many of the fibres descending in a cerebral peduncle synapse in scattered nuclei of the ipsilateral half of the basal pons.
These nuclei in turn project their fibres across the midline.
They then funnel into the middle cerebellar peduncle and finally enter the cerebellum.
The entry and exit of Cranial Nerves around the pons.
The trigeminal nerve (CN V) enters the brain-stem at the midpons.
Your Answer. a
Correct Answer. a
(32).
Both genioglossus muscles pull the tongue forward. Remember that if only one of the muscle functions, the tip of the tongue points
to the side of the resting or paralysed muscle.
Your Answer. c
Correct Answer. c
13/119
(33).
The long axis of the uterus is normally bent anteriorly on the long axis of the vagina.
The angle so formed,usually about 90, is called the angle of anteversion. So the uterus is said to be anteverted
Your Answer. c
Correct Answer. c
(34).
The calcarine sulcus is also an eg of Axial sulcus ( grows in the axis of visual lobe ).
Your Answer. b
Correct Answer. a
(35).
14/119
(36).
(37).
White matter of CNS are classified as Association, Projection & Commissural fibres. Uncinate fasciculus is an example of
association fibers.
They connect frontal ( Brocas area no 44, 45 ) & temporal ( Wernikes area no 22 ) lobes.
Your Answer. a
Correct Answer. a
(38).
The olivocerebellar fibres passes through the inferior cerebellar peduncle, pontocerebellar through MCP.
15/119
(39).
A right-leg paralysis characterized as spastic may indicate damage to :a. The medial aspect of the left precentral gyrus
b. The lateral aspect of the right precentral gyrus
c. The anterior horn cell
d. The right fasciculus gracilis
Solution. (a) The medial aspect of the left precentral gyrus
Ref: Read the text below
Sol :
The precentral gyrus of the frontal lobe is the primary motor cortex giving rise to the descending corticospinal tract.
The homuncular organization localizes lower limb innervation to the medial aspect of the precentral gyrus. The descending
corticospinal tract has its cells of origin in the contralateral cerebral cortex.
Spasticity is one of the cardinal findingsin an upper motor neuron syndrome. If the anterior horn cells are involved, the
presentation has features of a lower motor neuron syndrome, specifically, a flaccid paralysis.
The fasciculus gracilis is an ascending sensory pathway. A lesion of this pathway may produce ataxia but not paralysis.
Your Answer. a
Correct Answer. a
(40).
An aneurysm near the bifurcation of the internal carotid artery into the anterior and middle cerebral arteries produces deficits.
With which of the following cranial nerves are they most likely to be associated ?
a. Oculomotor
b. Trigeminal
c. Trochlear
d. Optic
Solution. (d) Optic
Ref: Read the text below
Sol :
The optic nerve (and chiasma) is located lateral to the bifurcation of the internal carotid into its two main terminal branches.
An enlargement of the vessel may encroach upon the optic nerve and produce visual field deficits.
Your Answer. b
Correct Answer. d
(41).
The nucleus that gives rise to motor fibers that innervate muscles of larynx, pharynx, and palate
is the:a. Hypoglossal nucleus
b. Nucleus ambiguus
c. Nucleus solitarius
d. Dorsal motor nucleus of the vagus
Solution. (b) Nucleus ambiguus
Ref: Read the text below
Sol :
The nucleus ambiguus gives rise to the motor innervation of larynx, pharynx, and palate. The hypoglossal nucleus innervates the
tongue muscle.
The dorsal motor nucleus of the vagus is comprised of parasympathetic preganglionicneurons that innervate the viscera.
The Edinger-Westphal nucleus is comprised of preganglionicparasympathetic neurons that innervate the smooth muscles of the
eye (sphincter pupillae and ciliary apparatus).
Your Answer. d
Correct Answer. b
16/119
(42).
The latissimus dorsi is responsible for extension, adduction, transverse extension also known as horizontal abduction,
flexion from an extended position, and (medial) internal rotationof the shoulder joint. It also has a synergisticrole in extension
and lateral flexion of the lumbar spine.
Most latissimus dorsi exercises concurrently recruit the teres major, posterior fibres of the deltoid, long head of the triceps
brachii, among numerous other stabilizing muscles.
Compound exercises for the 'lats' typically involve elbow flexion and tend to recruit the biceps brachii, brachialis, and
brachioradialisfor this function.
Depending on the line of pull, the trapeziusmuscles can be recruited as well; horizontal pulling motions such as rows recruit
both latissimus dorsi and trapezius heavily.
Your Answer. d
Correct Answer. a
(43).
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(44).
(45).
Sudden standing evokes the baroreceptor reflex. Which one of the following will be greater after a person suddenly stands up than it
was before the person stood?
a. The end-diastolic volume
b. The renal blood flow
c. The venous return
d. The ejection fraction
Solution. (d) The ejection fraction
Ref: Read the text below
Sol :
When a person rises suddenly, blood pools in the dependent portions of the body, causing decreases in venous return, left
ventricular end-diastolic volume, stroke volume, and pulse pressure.
The reduced stroke volume leads to a drop in cardiac output and, therefore, a drop in blood pressure.
Decreased blood pressure produces the baroreceptor reflex, leading to an increase in sympathetic activity, which increases total
peripheral resistance, cardiac contractility,heart rate, and ejection fraction.
These changes in the cardiovascular system return blood pressure toward normal.
Your Answer. d
Correct Answer. d
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(46).
Thrombin, the enzyme ultimately responsible for the formation of fibrin monomers, is generated from prothrombin by
activated factor X.
Activation of factor X occurs via both extrinsic and intrinsic pathways. Kininogens are enzymes responsible for the production
of peptides (kinins) associated with inflammation.
Plasminogen is the inactive precursor of plasmin, the proteolytic enzyme involved in clot dissolution. Heparin is an anticlotting
agent that is found on endothelial cell surfaces.
Your Answer. c
Correct Answer. c
(47).
The afterload is the force that the sarcomeres must overcome in order to shorten during systole. According to the law of
Laplace, this force is proportional to the pressure (P) and radius (r) of the ventricle during ejection (force P r).
The mean left ventricular systolic pressure would therefore be the best index of afterload.
Although total peripheral resistance can influence afterload by causing changes in mean arterial blood pressure, these factors
can only influence afterload by causing a change in ventricular pressure.
Pulmonary capillary wedge pressure and left ventricular end-diastolic pressure are estimates of the volume of blood in the
ventricle during diastole and are indices of preload.
Your Answer. d
Correct Answer. b
(48).
The principal paracrine secretion involved in the inhibitory feedback regulation of gastric acid secretion is
a. Gastrin
b. Somatostatin
c. Histamine
d. Enterogastrone
Solution. (b) Somatostatin
Ref: Read the text below
Sol :
Somatostatin, located within the SS cells of thegastric antral mucosa, is the principal paracrine secretion involved in the
inhibitory feedback of gastric acid secretion.
In humans, gastric acid secretion by the parietal cell occurs in response to excitatory neural (acetylcholine), hormonal (gastrin), and
paracrine (histamine) stimuli. Inhibitory feedback regulation of acid output also involves neural (enterogastric reflex), hormonal
(enterogastrone), and paracrine (somatostatin) influences.
Your Answer. b
Correct Answer. b
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(49).
The sodium-potassium pump (Na+,K+-ATPase) maintains a low intracellular Na+ concentration. Decreasing the activity of
Na+,K+-ATPase leads to an accumulation of intracellular Na+.
The osmotic activity of the increased intracellular Na+ pulls water into the cell, causing the cell to swell.
As Na+ enters the cell and K+ leaves the cell, the concentration gradients across the cell membrane are dissipated and the
cell depolarizes.
(50).
The amount of potassium excreted is controlled by the amount of potassium secreted by the distal tubule.
Potassium secretion is a passiveprocess that depends on the electrochemical gradient between the distal tubular cells and the
tubular lumen and the permeability of the luminal cells to potassium.
By inhibiting Na+ reabsorption, the intraluminal potential becomes less negative and K+ secretion is reduced.
K+-sparing diuretics such as amiloride act in this fashion. Aldosterone increases the intracellular potassium concentration by
augmenting the activity of the Na-K pump and increasing the potassium permeability of the luminal membrane.
Increasing dietary intake increases the plasma potassium concentration, which in turn stimulates aldosterone production. Increasing the
rate of distal tubular flow increases secretion by maintaining a low potassium concentration within the filtrate and thus increasing
the electrochemical gradient for potassium. The presence of nonreabsorbable organic anions will increase the electrochemical
gradient for K+ and therefore increase K+ excretion.
Your Answer. d
Correct Answer. d
20/119
(51).
The amount of fluid filtered by the glomerulus (the GFR) will increase if filtration pressure rises or plasma oncotic pressure
decreases.
Decreasing the plasma protein concentration decreases the capillary oncotic pressure, which leads to an increase in GFR.
If the afferent arteriolar resistance increases without an increasein perfusion pressure, the pressure within the glomerulus
will decrease, causing a decrease in GFR. A similar result will occur if the efferent arteriolar resistance falls.
Increasing sympathetic nerve activity to the kidney decreases renal blood flow and increases Na+ and water
reabsorption from the proximaltube, making it easier for the kidney to excrete concentrated urine.
Your Answer. a
Correct Answer. d
(52).
Phase-4 depolarization is caused by the activationof a Na+ channel. The channel is called the funny channel because it is
activated when the membrane hyperpolarizes in contrast to the Na channel responsible for the action potential, which is activated
when the cell depolarizes.
Potassium conductance decreases during phase-4 depolarization and thus the flow of potassium out of the cell is diminished.
However, this change in potassium current is not responsible for phase-4 depolarization.
Chloride conductance does not change during phase 4. The Na/Ca exchanger maintains low intracellular calcium at rest and
may reverse its direction and pump calcium into the cell during phase 2 of the cardiac action potential.
However, neither the Na/Ca exchanger nor the Na-K pump is involved in phase-4 depolarization
Your Answer. a
Correct Answer. a
(53).
The increased volume of blood in the right ventricle pushes the intraventricular septum toward the left ventricle, resulting in a
decreased filling of the left ventricle.
The decrease in left ventricular preload results in a decreased left ventricular stroke volume and a decrease in systemic blood
pressure
Your Answer. d
Correct Answer. d
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(54).
Self-stimulation could be induced experimentally most effectively from which part of brain ?
a. Periaqueductal area (Area around the aqueduct of Sylvius)
b. Periventricular region of hypothalamus
c. Medial forebrain bundle
d. Mesencephalon
Solution. (a) Periaqueductal area (Area around the aqueduct of Sylvius)
Ref:Read the text below
Sol :
The options in the above question are all components of the endogenous pain suppression system (also called the descending pain
inhibiting pathway), therefore the term self stimulation here probably refers to this endogenous pain suppression or analgesia system in
the brain and spinal cord,
The analgesia system consists of three components:
(1) Periacqueductal gray and periventricular areas of the mesencephalon and upper pons that surround the acqueduct of
Sylvius and portions of the 3rd and 4th ventricles.
Neurons from these areas secrete enkephalin at their endings, sending signals to
(2)Raphe magnus nucleus in the lower pons and upper medulla, and the nucleus paragigantocellularis located laterally in the medulla.
From these nuclei, serotonergic neurons travel down the dorsolateral columns in the spinal cord to
(3) Enkephalinergic neurons in the dorsal horn of the spinal cord - enkephalin from these neurons causes both pre and post
synaptic inhibition of the pain pathway.
Electrical stimulus either in the periacqueductal gray or raphe magnus nucleus can suppress many strong pain signals
entering by way of the dorsal spinal roots.
Also stimulation of other areas, such as the periventricular area of hypothalamus and to a lesser extent, the medial forebrain bundle,
also in the hypothalamus, excite the PAG, thereby causing suppression of pain transmission.
Your Answer. a
Correct Answer. a
(55).
Lateral spinothalamic tract carries pain and temperature from the opposite side.
To relieve pain in the right leg ventrolateral cordotomy will interrupt the left lateral spinothalamic tract.
Your Answer. b
Correct Answer. c
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(56).
The pressure in the space between the two layers of pleura is subatmospheric: -2.5 mms of Hg (w.r.t atmosphere) at the start of
inspiration, decreasing to -6 mms of Hg at the end of inspiration.
This is because the lungs and chest wall are elastic structures with a tendency to recoil in opposite directions- lungs tend
to recoil towards the inside and the chest wall tends to recoil towards the inside.
The lungs are stretched when they expand during inspiration, and at the end of quiet expiration (functional residual capacity) their
tendency to recoil from the chest wall is just balanced by the tendency of the chest wall to recoil in the opposite direction (at
FRC the lung recoil is equal to and is balanced by the chest wall recoil- FRC is also k/a relaxation volume of the lungs).
If the chest wall is opened, the lungs collapse; and if the lungs lose their elasticity, the chest expands and becomes barrel shaped.
Your Answer. a
Correct Answer. a
(57).
All of the following associations of hormones site of production and chemical structure are correct except
a. Androgens zona reticularis of adrenal cortex steroid
b. Vasopressin zona glomerulosa of adrenal cortex steroid
c. Cortisol zona fasiculata of adrenal cortex steroid
d. Norepinephrine adrenal medulla cate cholamine
Solution. (b) Vasopressin zona glomerulosa of adrenal cortex steroid
Ref:Read the text below
Sol :
Vasopressin and oxytocinare peptides that are synthesized in the hypothalamus and secreted from the posterior pituitary.
The adrenal cortex synthesizes three types of steroid hormones including glucocorticoids (e.g., cortisol) in the zona fasiculata,
mineralocorticoids (e.g., aldosterone) in the zona glomerulosa, and androgens in the zona reticularis.
The adrenal medulla synthesizes catecholamines including norepinephrine. The pancreatic lslet secrete the peptide hormones insulin
(-cells) and glucagon (-cells), as well as other hormones.
Your Answer. b
Correct Answer. b
(58).
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(59).
(60).
Fluoroquinolones (ciprofloxacin) act by inhibiting bacterial DNA gyrase. What is the function of DNA gyrase?
a. Unwind the DNA
b. Relieve torsional strain on DNA
c. Initiation of transcription
d. Synthesis of Okazaki Fragments
Solution. (b) Relieve torsional strain on DNA
Ref Read the text below
Sol:
TOPOISOMERASE
Relieves the torsional strain produced by unwinding of DNA
The enzyme causes nicks in the DNA by transesterification and not by hydrolysis of phosphodiester bond
Topoisomerase I:
-Makes single stranded nicks in the DNA
- Relieves positive and negative supercoils in eukaryotes
- Requires no ATP
Topoisomerase II:
-Relives positive and negative supercoiling
-Can introduce negative supercoiling
-Requires ATP
-DNA gyrase is a subset of Topoisomerase II.
Your Answer. b
Correct Answer. b
24/119
(61).
Barbiturates
Percidin-A
Rotenone
Malonate
TTFA
CarboxinE
BAL
Via complex-III Antimycin-A
Cyanide
CO
Via complex -IV H2S
Sodium azide
Your Answer. c
Correct Answer. d
(62).
2 types:
-Constitutive: always occurs in condensed form; seen in centromere and ends of telomere.
-Facultative: at times condensed and at other times actively transcribed.
Your Answer. a
Correct Answer. a
25/119
(63).
Hexokinase (I-III)
Glucokinase (hexokinase 4)
Found in
Km
High
Low
Stability
More
Less(labile)
Phosphorylate
Any hexose
Glucose specific
Allosteric inhibition
Fructose-6- phosphate
Glucose feeding
No change
Increased
Insulin
Induce
Induce
GH, glucocorticoids
Inhibit
Inhibit
Fasting/Diabetes Mellitus
Decreased
Your Answer. a
Correct Answer. a
26/119
(64).
Marker
Nucleus
DNA
Mitochondria
Glutamate dehydrogenase
Endoplasmic reticulum
Glucose-6-phosphatase
Lysosome
Acid phosphatase
Plasma membrane
5 nucleotidase
Na+ K+ ATPase
Adenylyl cyclase
Golgi Apparatus
Cis-golgi
Medial-golgi
Trans-golgi
TGN (Trans golgi network)
Galactosyl transferase I
Golgi mannosidase II
Galactosyl transferase
Sialyl transferase
Peroxisomes
Catalase
Cytosol
Lactate dehydrogenase
Intermitochondrial
membrane
ATP synthase
Your Answer. c
Correct Answer. c
(65).
27/119
(66).
(67).
A ten year old child with aggressive behavior and poor concentration is brought with presenting complaints of joint pain and
reduced urinary output. Mother gives history of self mutilative behavior, stating that he tends to mutilate his fingers. Which of the
following is likely to be elevated in this child?
a. Blood sugar
b. Serum creatinine
c. Uric acid
d. Blood urea
Solution. (c) Uric acid
Ref Read the text below
Sol:
Self mutilative behavior typically affecting fingers, evidence of joint pain (due to hyperuricemia) And reduced urinary output
together with features of compulsive aggression suggest a diagnosis of Lesch -Nyhan syndrome
Lesch Nyhan syndrome is caused by a complete deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRTase).
The excess of purines are catabolized resulting in elevated levels of uricacid.
Your Answer. c
Correct Answer. c
(68).
Heparin is a:
a. Glycoprotein
b. Glycosaminoglycan
c. Lipoprotein
d. Protein
Solution. (b) Glycosaminoglycan
Ref Read the text below
Sol:
28/119
(69).
Examples are:
Trypsin
Chymotrypsin
Elastase
Thrombin
Your Answer. c
Correct Answer. c
(70).
The method can be used to amplify DNA sequences from any source:bacterial, viral, plant or animal
PCR utilizes DNA polymerase to repetitively amplify targeted portions of DNA Requirements
DNA to be amplified
Primer RNA
Deoxynucleotides
But it is necessary to know the nucleotide sequence of short segments on each side of target DNA-flanking sequences
2. Denature the DNA:
The DNA to be amplified is heated to separate the double stranded target DNA into single strands
This is done by heating at 92-96 C for 10 minutes
3. Annealing of primers to ssDNA:
The separated strands are cooled and allowed to anneal to the two primers (one each strand)
DNA polymerase and deoxyribonucleoside triphosphates are added to the mixture to initiate the synthesis of two new chains
complementary to the original DNA
Your Answer. d
Correct Answer. d
29/119
(71).
Class B scavenger receptor B1 (SR-B1) and ATO binding cassette transporter A1 (ABCA1) and G1 (ABCG1) are involved in reverse
cholesterol transport
Pre -HDL is the most potent form of HDL for cholesterol removal from tissues
HDL is the highest density lipoprotein (maximum protein content & least lipid content)
D. HDL has the highest electrophoretic mobility.
Your Answer. d
Correct Answer. b
(72).
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(73).
Mitochondrial codons are an exception for the property of universality of codons. For eg: Initiation codon in mammals is AUG,
which codes for methionine. But in mitochondria, methionine is coded by some other codon. Which among the following is that
initiation codon?
a. AAG
b. AUG
c. AUA
d. AGA
Solution. (c) AUA
Ref Read the text below
Sol:
(74).
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(75).
All of the following statements are true regarding reversible cell injury except
a. Formation of amorphous densities in the mitochondrial matrix
b. Diminished generation of adenosine triphosphate (ATP)
c. Formation of blebs in the plasma membrane
d. Detachment of ribosomes from the granular endoplasmic reticulum
Solution. (a) Formation of amorphous densities in the mitochondrial matrix
Ref.:Read the text below
Sol :
Formation of Amorphous densities in mitochondrial matrix is a feature of irreversible injury and not reversible injury.
Your Answer. c
Correct Answer. a
(76).
(77).
In apoptosis, Apaf-1 is activated by release of which of the following substances from the mitochondria?
a. Bcl 2
b. Bax
c. Bcl Xl
d. Cytochrome C
Solution. (d) Cytochrome C
Ref.:Read the text below
Sol :
Apoptosis is induced by a cascade of molecular events all of the which culminate in the activation of caspases.
In the cytosol cytochrome C binds to a protein called Apaf I (Apoptosis activating factor 1) and the complex activates caspase 9
Your Answer. a
Correct Answer. d
32/119
(78).
(79).
Fluoroscent stains
Immunohistochemistry
Stain used Various antibody stains against the specific antigenic protein
types e.g. Anti
AP, anti AA, anti Lambda, anti kappa
Your Answer. b
Correct Answer. c
33/119
(80).
(81).
Which of the following chemical mediators of inflammation is an example of a C-X-C or alpha chemokine
a. Lipoxin LXA 4
b. Interleukin IL-8
c. Interleukin IL-6
d. Monocyte Chemoattractant Protein MCP 1
Solution. (b) Interleukin IL-8
Ref.:Read the text below
Sol :
Interleukin-8 (IL-8), growth-related oncogene (GRO) alpha, GRObeta, GROgamma, neutrophil-activating peptide-2 (NAP-2), epithelial
cell-derived neutrophil activating peptide- 78 (ENA-78), and granulocyte chemoattractant protein-2 are potent neutrophil
chemoattractants 40-90% identical in amino acid sequence that comprise a subgroup of human CXC chemokines defined by
the conserved sequence motif glutamic acid-leucine-arginine (ELR).
Neuropeptides
Neuropeptides are secreted by sensory nerves and various leukocytes, and play a role in the initiation and propagation of an
inflammatory response.
Substance P and neurokinin A, belong to a family of tachykinin neuropeptides are produced in CNS & PNS.
Substance P has many biological functions, e.g. pain transmission, regulation of BP, increasing vascular permeability and stimulation
of secretion of endocrine cells.
Nerve fibres containing substance P are prominent in the lung and gastrointestinal tract.
Sensory neurons also produce calcitonin-related gene product, a pro inflammatory molecule, involved in protective host response
of sensing of painful stimuli.
Your Answer. d
Correct Answer. b
34/119
(82).
(83).
(84).
Patau syndromedue to
a. Trisomy 21
b. Trisomy 18
c. Trisomy 13
d. Trisomy 15
Solution. (c) Trisomy 13
Ref.:Read the text below
Sol :
Trisomies occur when there is a triplet of a specific chromosome instead of the normal number of 2.
In Patau syndrome there is an extra chromosome 13 resulting in multiple and often severe physical and mental
abnormalities.
Some physical characteristics are flattened facial features, malformed and low-set ears, cleft lip and/or palate, prominent
heels, and genital malformations. Often there are problems with the nervous system, including forebrain development, spinal cord
development, mental retardation, and seizures.
Vision and eye problems are common, as well as respiratory and heart defects. Approximately 45% of Patau syndrome
babies die within the first month of life, while the number increases to 70% in the first 6 months.
Your Answer. c
Correct Answer. c
35/119
(85).
(86).
A patient presents with respiratory symptoms i.e. cough, hemoptysis and glomerulonephritis. His C-ANCA levels in serum were
found to be raised. The most likely diagnosis is
a. Goodpasteurs syndrome
b. Classic polyarteritis nodosa
c. Wegeners granulomatosis
d. Kawasaki syndrome.
Solution. (c) Wegeners granulomatosis
Ref.:Read the text below
Sol :
Renal and pulmonary symptoms with positive c-ANCA suggest the diagnosis of wegners glomerulonepritis
Clinical syndrome of wegner granulomatosis may be very similar to classical PAN or microscopic polyangitis.
Your Answer. c
Correct Answer. c
36/119
(87).
(88).
(89).
In myocardial infarction the infarct acquires hyperemic rim with an yellow centre at
a. 3-7 days
b. 10-20 days
c. 7-14 days
d. 1-2 hours
Solution. (a) 3-7 days
Ref.:Read the text below
Sol :
3 7 days Findings
Gross examination
Hyperemiaat border
Necrosis of neutrophils
Beginning of macrophageremoval of dead cells at border
Your Answer. a
Correct Answer. a
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(90).
(91).
38/119
(92).
(93).
The most common organisms which cause lobar pneumonia are Streptococcus pneumoniae, also called pneumococcus,
Haemophilus influenzaeand Moraxella catarrhalis. Mycobacterium tuberculosis, the tubercle bacillus, may also cause lobar pneumonia if
pulmonary tuberculosisis not treated promptly.
The identification of the infectious organism (or other cause) is an important part of modern treatment of pneumonia.
The anatomical patterns of distribution can be associated with certain organisms, and can help in selection of an antibiotic
while waiting for the pathogen to be cultured.
Your Answer. c
Correct Answer. c
39/119
(94).
(95).
Serotonin (5-HT) is one of several mediators of the signs and symptoms of carcinoid tumor.When released from this neoplasm, most
of the manifestations of 5-HT are the result of activation of the 5-HT2 receptor. These manifestations are therefore likely to
include which of the following effects?
a. Bronchospasm
b. Constipation
c. Skeletal muscle weakness
d. Tachycardia
Solution. (a) Bronchospasm
Ref:Read the text below
Sol:
5-HT2 receptors mediate smooth muscle contraction and thus cause bronchospasm and diarrhea, not constipation.
Peptic ulceration is not mediated in part by 5-HT; the autacoid actually reduces acid secretion.
Your Answer. a
Correct Answer. a
40/119
(96).
Which of the following drugs is useful in asthma because it stabilizes mast cells?
a. Albuterol
b. Cromolyn
c. Ipratropium
d. Salmeterol
Solution. (b) Cromolyn
Ref:Read the text below
Sol:
Albuterol is a shorter acting beta-2-selective agonist that is used for acute, not prophylactic, therapy.
Salmeterolhas a long duration beta-2-agonist action that appears to have an anti-inflammatory action and is useful in prophylaxis of
asthmatic attacks.
It has a slow onset of action that makes it useless in treating acute attacks.
Your Answer. b
Correct Answer. b
(97).
Which of the following mechanisms most accurately describes the blocking action of methimazole?
a. Iodine uptake by the thyroid
b. Organification of iodine in the thyroid
c. Peripheral conversion of T4 to T3
d. Peripheral thyroxine (T4) and T3 receptors
Solution. (b) Organification of iodine in the thyroid
Ref:Read the text below
Sol:
Methimazole (and other thioamides) act primarilyby inhibiting thyroid peroxidase, the critical enzyme in iodine organification.
They do not block iodine uptake by the gland. Block of iodine uptake by the thyroid is a property of antithyroid anions such as
thiocyanate (SCN) and perchlorate (ClO4 ).
Inhibition of peripheral conversion of T4 to T3 is the mechanism of beta blockers and iodine-containing radio-opaque
drugs such as ipodate.
Block of peripheral thyroid receptors is not a mechanism of any currently available drug.
Your Answer. b
Correct Answer. b
(98).
Which of the following antitubercular agents is a strong inducer of hepatic cytochrome P450?
a. Ethambutol
b. Isoniazid
c. Rifampin
d. Streptomycin
Solution. (c) Rifampin
Ref:Read the text below
Sol:
Rifampin selectivelyinhibits bacterial DNA-dependent RNA polymerase. It is very useful in treating mycobacterial infections
since it can penetrate cells and kill intracellular organisms.
It is one of the most potent inducers of cytochrome P450 known, leading to increased hepatic clearance of many other drugs
including the oral anticoagulants, cyclosporine, propranolol, digitoxin, corticosteroids, and oral contraceptives.
Ethambutol is often combined with isoniazid in antitubercular regimens. Clearance is primarily via renal excretion.
Isoniazid is the mostwidely used antitubercular agent. It functions by inhibiting mycolic acid biosynthesis.
Your Answer. c
Correct Answer. c
41/119
(99).
A 35-year-old woman with hypertension is planning to become pregnant. Which of the following is contraindicated in pregnancy?
a. Clonidine
b. Hydralazine
c. Hydrochlorothiazide
d. Losartan
Solution. (d) Losartan
Ref:Read the text below
Sol:
Losartan causes renal damagein the fetus, and renal impairment in renovascular disease. It is contraindicated in pregnancy.
Clonidine causessome sedation and rebound hypertension when stopped suddenly, but is not contraindicated in pregnancy.
(100).
A35-year-old opera singer has been treated for hypertension with enalapril. Although his blood pressure has been reduced, he
complains that he is now unable to perform because of a dry cough. Which of the following acts by a similar but not identical
mechanism and is much less likely to cause cough?
a. Captopril
b. Clonidine
c. Losartan
d. Prazosin
Solution. (c) Losartan
Ref:Read the text below
Sol:
Losartan, an AT1 receptor-blocking agent, has effects in hypertension similar to those of ACE inhibitors but causes a much lower
incidence of cough.
Captopril and other ACE inhibitorscause a dry cough in 520% of patients. This may be due to accumulation of bradykinin as a
result of ACE inhibition; ACE also metabolizes bradykinin. The cough disappears with cessation of ACE inhibitor treatment.
Pretreatment with aspirin reduces its frequency and severity in some patients.
Clonidine the centrally acting alpha- 2-receptor agonist, produces sedation and xerostomia but not cough.
The alpha-1-receptor antagonist prazosin produces postural hypotension but not cough.
The betablocker propranolol may produce a variety of side effects including precipitating heart failure and asthma in susceptible
patients.
It does not cause cough. Propranolol has been used by musicians to control palpitations associated with stage fright.
Your Answer. c
Correct Answer. c
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(101).
The unique feature of atracurium is inactivation in plasma by spontaneous non enzymatic degradation (Hofmann elimination) in
addition to that by cholinesterases.
Consequently its duration of action is not altered in patients with hepatic / renal insufficiency or hypodynamic circulation.
(102).
Mebendazole may be used for treatment of all of the following conditions except:
a. Enterobiasis
b. Ascariasis
c. Hook worm disease
d. Hook worm disease
Solution. d) Strongyloidiasis
Ref:Read the text below
Sol:
(103).
The blood culture from a patient of febrile neutropenia has grown pseudomonas aeruginosa,it was found to be a producer of
extended spectrum beta lactamase enzyme. The best choice of antimicrobial therapy should be:
a. Ceftazidime + Amikacin
b. Aztreonam + Amikacin
c. Cefpirome + Amikacin
d. Imipenem + Amikacin
Solution. d) Imipenem + Amikacin
Ref:Read the text below
Sol:
CARBAPENEMS
Carbapenems are synthetic that differ from the penicillins in that the sulfur atom of the thiazolidine ring has been externalized and
replaced by a carbon atom.
Imipenem is the only drug of this group currently available.
Antibacterial spectrum:
1. Imipenem/cilastatin is the broadest spectrum -lactam antibiotics preparation currently available.
3. The drug plays a role in empiric therapy since it is active against penicillinase-producing grampositive and gram-negative
organisms, anaerobes, an pseudomonas aeruginosa,although other pseudomonas strains are resistant.
Your Answer. a
Correct Answer. d
43/119
(104).
A patient with cancer received extreme degree of radiation toxicity. Further history revealed that the dose adjustment of a particular
drug was missed during the course of radiotherapy. Which of the following drugs required a dose adjustment in that patient during
radiotherapy in order to prevent radiation toxicity:
a. Vincristine
b. Dactinomycin
c. Cyclophosphamide
d. 6-Mercaptopurine
Solution. (b) Dactinomycin
Ref:Read the text below
Sol:
Your Answer. c
Correct Answer. b
(105).
Gentamycin, obtained from Micromonospora purpura, has become the most commonly usedaminoglycoside for acute infections; but
is ineffective against: a. Klebsiella
b. Strep.pyogenes
c. Proteus
d. Pseudomonas
Solution. (b) Strep.pyogenes
Ref:Read the text below
Sol:
Gentamicin has a broader spectrum of action: effective against Ps. aeruginosa and most strains of Proteus, E. coli, Klebsiella,
Enterobacter, Serratia.
It is ineffective against M.tuberculosis, Strep. pyogenes and Strep. pneumoniae, but inhibits many Strep.faecalis and some
Staph.aureus.
Your Answer. d
Correct Answer. b
(106).
The increased risk of blood clots in women who use certain combined estrogen/progestin birth control pills is well established.
Which of the following best explains this association?
a. Impaired glucose tolerance
b. Increased Factor II, VII, IX, and X levels produced by estrogens
c. Increased plasminogen levels produced by progestins
d. Increased thyroxine-binding globulin
Solution. (b) Increased Factor II, VII, IX, and X levels produced by estrogens
Ref:Read the text below
Sol:
Increased clotting factor synthesis (and decreased antithrombin III synthesis) caused by estrogens are the major factors
responsible for increased incidence of thromboembolic phenomena. Glucose tolerance is impaired in some women by progestins and
would not be expected to affect clotting.
Thyroxine-binding globulin is also increased by estrogen, but would have little effect on clotting.
Triglycerides are increased by estrogens and would have little or no effect on clotting.
Your Answer. b
Correct Answer. b
44/119
(107).
Which of the following drugs is considered afirst-line agent in the chronic treatment of rheumatoid arthritis and in the
treatment of choriocarcinoma?
a. Cyclosporine
b. Hydroxychloroquine
c. Methotrexate
d. Sulfasalazine
Solution. (c) Methotrexate
Ref:Read the text below
Sol:
Methotrexate in very low dosagehas proven effective in slowing the progression of rheumatoid arthritis and has low toxicity.
It is also one of the most effective (in much higher dosage) antimetabolite cancer chemotherapeutic drugs used in
choriocarcinoma.
Cyclosporine is not used in either condition but is a first-line drug in transplant immunopharmacology.
Hydroxychloroquine is a disease-modifying antirheumatoid arthritis drug, but has no efficacy in the treatment of cancer. It is more
toxic and less effective in rheumatoid arthritis than methotrexate.
Sulfasalazine is also effective in slowing the progression of joint damage in rheumatoid arthritis but has no efficacy in
cancer.
Your Answer. c
Correct Answer. c
(108).
Which of the following laxatives acts osmotically to increase the water content of the stool?
a. Cascara
b. Docusate
c. Glycerine
d. Magnesium hydroxide
Solution. (d) Magnesium hydroxide
Ref:Read the text below
Sol:
Magnesium hydroxideis an osmotic laxative that retains water in the lumen of the colon.
Cascara is a naturally occurring plant product that stimulates the bowel and causes evacuation within 612 hours when given orally.
(109).
Which of the following drugs binds to, and prevents disassembly of, microtubules?
a. Busulfan
b. Cisplatin
c. Mercaptopurine
d. Paclitaxel
Solution. (d) Paclitaxel
Ref:Read the text below
Sol:
Busulfan and cisplatin are alkylatingagents that interfere with DNAmobilization and replication.
Vinblastine and vincristineand vinorelbine are mitotic poisons that prevent cancer cell division by interfering with microtubule
assembly and thus immobilizing the mitotic spindle apparatus.
Their indications and toxicities are quite different from those of paclitaxel.
Your Answer. d
Correct Answer. d
45/119
(110).
Which of the following drugs blocks the action of angiotensin II at the AT1 receptor?
a. Bradykinin
b. Enalapril
c. Losartan
d. Ondansetron
Solution. (c) Losartan
Ref:Read the text below
Sol:
Losartan and severalother drugs block the action of angiotensin II at its primary cardiovascular target, the AT1 receptor.
They are therefore useful in hypertension and heart failure. Bradykinin (choice A) is a vasodilator peptide.
(111).
Which of the following statements describes the major difference between zolpidem and older hypnotics such as barbiturates
and benzodiazepines?
a. Associated with thrombocytopenia
b. Does not act on chloride channels in the CNS
c. Has significant anticonvulsant activity
d. Reduced addiction liability
Solution. (d) Reduced addiction liability
Ref:Read the text below
Sol:
Zolpidem has greatly reduced addiction liability compared to barbiturates and benzodiazepines even though it does act on
chloride channels.
Zolpidem does not havemajor anticonvulsant actions, a longer duration of action, or thrombocytopenic toxicity.
Your Answer. d
Correct Answer. d
(112).
Which of the following drugs is used in cerebral palsy to reduce skeletal muscle spasticity by an action on cholinergic nerve endings?
a. Baclofen
b. Botulinum toxin
c. Dantrolene
d. Diazepam
Solution. (b) Botulinum toxin
Ref:Read the text below
Sol:
Botulinum toxin actson cholinergic nerve endings (including skeletal muscle motor nerve endings) to reduce acetylcholine release.
Baclofen acts in the CNS to activate GABAB receptors; some sedation may result.
Dantroleneacts within the skeletal muscle cell to reduce calcium release from the sarcoplasmic reticulum; reduction of muscle
spasm results without central nervous system depression.
Diazepam facilitates GABAergic transmission in the brain and spinal cord; it does not act on cholinergic transmission.
Your Answer. a
Correct Answer. b
46/119
(113).
Which of the following drugs is most likely to cause parkinsonian adverse effects?
a. Clozapine
b. Fluphenazine
c. Haloperidol
d. Olanzapine
Solution. (c) Haloperidol
Ref:Read the text below
Sol:
Haloperidol is a verypotent and efficacious antipsychotic but also manifests the highest incidence of extrapyramidal effects.
Clozapine, olanzapine, and quetiapineare newer, atypical antipsychotic agents with much lower incidence of extrapyramidal
toxicity.
Your Answer. c
Correct Answer. c
(114).
Apatient has been treated for bipolar disorder for several months. Which of the following is a common adverse effect of lithium
carbonate?
a. Dry mouth
b. Hyperthyroidism
c. Leukopenia
d. Nephrogenic diabetes insipidus
Solution. (d) Nephrogenic diabetes insipidus
Ref:Read the text below
Sol:
Dry mouth and other anticholinergic toxicities are common with tricyclic antidepressants and some phenothiazines.
Similarly, lithium increases rather than decreases white blood cell count
Your Answer. a
Correct Answer. d
(115).
The people most likely to have heard from them have had no contact.
47/119
(116).
Eighthly.- Any hurt which endangers life or which causes the sufferer to be during the space of twenty days in severe bodily pain, or
unable to follow his ordinary pursuits.
Your Answer. c
Correct Answer. c
(117).
Holland 12 points
Germany 8 points
UK 16 points
India 8 points
Your Answer. b
Correct Answer. d
(118).
Commonest skull fracture is linear fracture/ Fissure fracture. However, this is not given in our options.
Depressed fracture/ signature fracture is the second most common fracture of skull.
Your Answer. a
Correct Answer. b
48/119
(119).
(120).
(121).
49/119
(122).
(123).
Phossy jawis seen in chronic poisoning with the fumes of Red phosphorus, seen in the industries where its use is rampant like
matchbox industry and incense making..
Your Answer. c
Correct Answer. c
(124).
In 2013, Indian Parliament made amendments to the Indian Penal Code, introducing voyeurism as a criminal offence.
A man committing the offence of voyeurism would be liable for imprisonment not less than one year and which may extend up to
three years for the first offence, and shall also be liable to fine and for any subsequent conviction would be liable for imprisonment for
not less than three year and which may extend up to seven years and with fine.
50/119
(125).
(126).
The mortality rate of SARS is higher than that of non-H5N1 influenza strains or other common respiratory tract infections.
The overall mortality rate of SARS has been approximately 10%. According to the CDC and the WHO, the death rate among
individuals older than 65 years exceeds 50%.
The WHO has set the SARS containment period at 20 days. If no new cases of SARS are reported in a given area over a 20-day
period, given the relatively short incubation period of the disease, the WHO considers SARS infections in that area to be
contained.
Your Answer. b
Correct Answer. b
(127).
The timeelapsed between exposure to a pathogenicorganism, a chemicalor radiation, and when symptomsand signs are first apparent is
a. Secondary attack rate
b. Incubation period
c. Latency
d. Serial interval
Solution. (b) Incubation period
Ref Read the text below
Sol:
Incubation periodis the timeelapsed between exposure to a pathogenicorganism, a chemicalor radiation, and when symptomsand
signs are first apparent. The period may be as short as minutes to as long as thirty years in the case of variant Creutzfeldt-Jakob disease.
While Latent or Latency period may be synonymous, a distinction is sometimes made between Incubation period, the period between
infection and clinical onset of the disease, and Latent period, the time from infection to infectiousness. Which is shorter depends on the
disease
Your Answer. b
Correct Answer. b
51/119
(128).
For the community diagnosis of trachoma, WHO recommends that follicular and intense trachoma inflammation should be assessed in:
a. Women aged 15-45 years
b. Population of 10-28 years
c. Children aged 0-10 years
d. Population above 25 years irrespective of sex
Solution. (c) Children aged 0-10 years
Ref: Read the text below
Sol:
According to WHO, prevalence of more than 5% severe and moderate trachoma in children under 10 years is an indication of
mass or blanket treatment consisting of twice daily application of ointmenttetracycline 1% or ointment erythromycin to all
children for 5 consecutive days each month or oncedaily for 10 days per month for 6 months or for 60 consecutive days.
Your Answer. d
Correct Answer. c
(129).
CONCEPT OF PREVENTION
No risk factors :
Primordial prevention(prevention OF EMERGENCE of risk factors)
Appearance of risk factors: Primary prevention Health promotion & Specific protection
Appearance of disease : Secondary prevention Early diagnosis & Disease treatment
Late pathogenesis phase: Tertiary prevention Disability limitation & Rehabilitation
Your Answer. d
Correct Answer. c
(130).
In a certain population, there were 4050 births in the last one year. There were 50 still births. 50 infants died within 7 days where as 150
died within 28 days. What is the NMR
a.
b.
c.
d.
a. 50
b. 49.6
c. 37.03
d. 69%
Solution. (c) 37.03
Ref: Read the text below
Sol:
Neonatal deathsare the deaths occurring during the neonatal period, commencing at birth and ending 28 completed days after
birth. Neonatal mortality rate is the number of neonatal deaths in a given year per 1000 live births in that year
NMR=Number of deaths of children under 28 days of age in a year1000/ Total live births in the same year.
52/119
(131).
Mortality experiences are taken into consideration when defining :a. General fertility rate
b. .Total fertility rate
c. Gross reproduction rate
d. Net reproduction rate (NRR)
Solution. (d) Net reproduction rate (NRR)
Ref: Read the text below
Sol:
NRR is defined as, the number of daughters a newborn girl will bear during her life time assuming fixed age specific fertility
and mortality rates.
It is the most significant indicator of fertility. NRR = 1 is alsoknown as replacement rate and coincides approximately to the two
child norm.
In a declared policy, Indiaaims to achieve NRR = 1 by 2006. In order to achieve NRR = 1, 60% of the eligible couples should
beeffectively practicing family planning (couple protection rate)
Your Answer. c
Correct Answer. d
(132).
Transmissionoccurs through via respiratory aerosols and respiratory droplet spread or by direct contact with contaminated saliva.
Mumps is communicable from six to seven days before to nine days after the onset of parotitis.
(133).
53/119
(134).
Infection that is transmissible under natural conditions from vertebrate animals to man is:
a. Zoonosis
b. Epizootic
c. Enzotic
d. Both b and c
Solution. (a) Zoonosis
Ref Read the text below
Sol:
Zoonosisis an infection that is transmissible under natural conditions from vertebrate animals to man, e.g. rabies, plague, bovine
tuberculosis..
An epizotic is an outbreak (epidemic) of disease in an animal population, e.g. rift valley fever.
(135).
The disease is constantly present at high incidence and/or prevalence rate and affects all age groups equally is:
a. Hyperendemic
b. Holoendemic
c. Exotic diseases
d. Epidemic
Solution. (a) Hyperendemic
Ref Read the text below
Sol:
The term hyperendemic expresses that the disease is constantly present at high incidence and/or prevalence rate and affects all
age groups equally.
The term holoendemic expresses a high level of infection beginning early in life and affecting most of the child population,
leading to a state of equilibrium such that the adult population shows evidence of the disease much less commonly than do the children
(e.g. malaria)
Exotic diseasesare those which are imported into a country in which they do not otherwise occur, as for example, rabies in the UK.
An epidemic usually affecting a large proportion of the population, occuring over a wide geographic area such as a section of a
nation, the entire nation, a continent or the world, e.g. Influenza pandemics.
Your Answer. a
Correct Answer. a
(136).
For patients with pulmonary tuberculosis who have a positive sputum smear or a chest x-ray that strongly suggests active
tuberculosis.
Specifications include use of a private room with special ventilation and closed door. In addition to the basic
requirements, respirator-type masks are used by those entering the room.
54/119
(137).
No Disease
Positive test
Negative test
Sensitivity= a/(a+c)
Specificity = d/(b+d)
Positive Predictive Value = a/(a+b)
Negative Predictive Value = d/(c+d)
Your Answer. a
Correct Answer. a
(138).
In the context of epidemiology, the following are important criteria for making casual inferences except.
a. Strength of association
b. Consistency of association
c. Coherence of association
d. Predictive value
Solution. (d) Predictive value
Ref Read the text below
Sol:
PREDICTIVE VALUE:
The predictive value of a test is a measure (%) of the times that the value (positive or negative) is the true value, i.e. the percent of all
positive tests that are true positives is the Positive Predictive Value.
__TP___ X 100 = Predictive Value of a Positive Result (%)
TP + FP
__TN___ X 100 = Predictive Value Negative Result (%)
Your Answer. b
Correct Answer. d
55/119
(139).
(140).
Which if the following conditions does not have a national screening/ control program
a. Dibetes Mellitus
b. Dental caries
c. Refractive errors
d. Carcinoma cervix
Solution. (b) Dental caries
Ref: Read the text below
Sol:
There is no national program in India for dental caries or oral health
The program for other diseases are:
i.
National program for control of blindness (NPCB)
ii.
National program for prevention and control of cancer, diabetes, cardiovascular disease and stroke (NPCDCS)
Your Answer. a
Correct Answer. b
56/119
(141).
A village is divided into 5 relevant subgroups for the purpose of survey. Individuals from each subgroups are then selected
randomly. This type of sampling is:
a. Simple random
b. Stratified
c. Cluster
d. Systematic random
Solution. (b) Stratified
Ref: Read the text below
Sol:
The village is divided into strata and then individuals are selected from each strata randomly.
(142).
An investigator observes that 5 independent risk factors influence the occurrence of disease. Which of the following test should be
applied to assess the relationship between these 5 risk factors and the occurrence of disease
a. ANOVA
b. Multiple linear regression
c. Multiple logistic regression
d. One way analysis of variance
Solution. (c) Multiple logistic regression
Ref: Read the text below
Sol:
The statistical test to assess the relationship between multiple independent risk factors and outcome is multiple logistic
regression analysis
Your Answer. b
Correct Answer. c
57/119
(143).
The systematic distortion of retrospective studies that can be eliminated by a prospective design is
a. Confounding
b. Effect modification
c. Recall bias
d. Measurement bias
Solution. (c) Recall bias
Ref: Read the text below
Sol:
Recall bias is a type of type of information bias that occurs when there are differences in how exposure groups or disease
groups remember certain information.
Other Biases are:
Several types of bias can occur.
1. Selection bias occurs when the case and controls selected for the study are not representative of the general population, hence the
results cant be generalized (loss of external validity).
2. Measurement bias Occurs while data collection and occurs when the subjects cant recall the events properly or the investigator is
biased in collecting data because of prior knowledge of the association between the risk factor and the disease, e.g. if the investigator is
studying the relationship between smoking and lung cancer he might take a more detailed questioning of the cases and not the controls
and thus exaggerate the relationship.
3. Confounding bias Occurs when the disease under study is associated with another factor apart from the risk factor under study. In
such a scenario it might be difficult to interpret the results, e.g. if we are studying the association between smoking and CHD; it is
possible that the cases also take alcohol, thus confounding the results. This bias can be minimized by matching.
Statistical procedures like regression analysis also help in detecting potential confounders.
4. Berkesonian Bias Differing rates of admissions to hospitals cause bias.
5. Surveillance bias: If the population is measured ove r a period of time, the dis ascertainment may be better in monitored population,
leading to erroneous estimate of OR/RR.
Your Answer. c
Correct Answer. c
(144).
Vaccines
Most sensitive
Least sensitive
BCG(after reconstitution)
OPV
Measles
Hepatitis B
DPT
DT
BCG(before reconstitution)
TT(Tetanus toxoid)
DPT
DT
TT
Hepatitis B
BCG(before reconstitution)
OPV
Measles(before reconstitution)
Storage Temperature:
A break in the cold chain is indicated if temperature rises above +8 C or falls below +2C in case of ILR and other
refrigerators.
Your Answer. b
Correct Answer. c
58/119
(145).
In STD cases, a patient is asked to name other persons is his socio sexual group, then they are investigated. This is a example of
a. Screening
b. Contact tracing
c. Mass screening
d. High risk screening
Solution. (b) Contact tracing
Ref Read the text below
Sol:
In epidemiology, contact tracing is the identification and diagnosis of persons who may have come into contact with an infected
person.
For sexually transmitted diseases, this is generally limited to sexual partners but for highly virulent diseases such
as Ebola and tuberculosis, a thorough contact tracing would require information regarding casual contacts.
Some AIDS activists have argued that contact tracing is counter-productivein that it would lead persons to avoid seeking medical
treatment for fear that it would breach their right to privacy.
Your Answer. b
Correct Answer. b
(146).
The lingual tonsils are rounded masses of lymphatic tissuethat cover the posterior region of the tongue.
They are located on the dorsal surface at the base of the tongue. Their lymphatic tissue are dense and nodular, their surface is
covered with stratified squamous epitheliumwhich invaginates as a single cryptinto each lingual tonsil.
They are partially surrounded by connective tissue placing them in the group of Partially Encapsulated Lymphatic Organs, tonsils,
the only one of its kind.
They have associated mucousglands which are drained by ducts directly into the single tonsillar crypt.
Your Answer. d
Correct Answer. d
(147).
59/119
(148).
(149).
Regarding laryngomalacia :
a. Most common cause of stridor in adult
b. Inspiratory stridor
c. Requires immediate surgery
d. Stridor worsens on laying in prone position
Solution. (B) Inspiratory stridor
Ref: Dhingra - 314
Sol :
Laryngomalacia : or congenital laryngeal stridor or congenital laryngeal stridor
Most common congenital anomaly of larynx.
Most common condition causing inspiratory stridor at or shortly after birth.
In most cases, it is asymptomtic.
M:F=1:1
There is abnormal flaccidity of laryngeal cartilage. Stridor occurs as a result of prolapsed of supraglottic structures into the
laryngeal inlet on inspiration.
Your Answer. b
Correct Answer. b
60/119
(150).
(151).
vomer bone
(152).
Sensorineural hearing loss(SNHL) is a type of hearing lossin which the root cause lies in the vestibulocochlear nerve(cranial
nerveVIII), the inner ear, or central processing centers of the brain. Sensorineural hearing loss can be mild, moderate, or severe,
including total deafness.
61/119
(153).
(154).
Ozena, which is also called rhinitissicca or atrophic rhinitis, is a rare disorder of the nasal passages. It occurs most often in arid
regions such as India, Egypt and the Middle East as well as in many other developing nations.
Rhinitis siccais most commonly seen on anterior nares.
Your Answer. a
Correct Answer. a
(155).
Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis or glottal papillomatosis, is a rare medical
condition(2 per 100,000 adults and 4.5 per 100,000 children), caused by a HPVinfection of the throat.
Laryngeal papillomatosis causes assorted tumorsor papillomasto develop over a period. Without treatment it is potentially fatal as
uncontrolled growths could obstruct the airway.
Laryngeal papillomatosis is caused by HPV types 6 and 11, in which benign tumors form on the larynx or other areas of the
respiratory tract
62/119
(156).
All of the following are diagnostic signs of cervical sympathetic trunk injury except :
a. Ptosis
b. Dilated pupil
c. Miosis
d. Anhidrosis
Solution. (b) Dilated pupil.
Ref Read the text below
Sol:
The superior tarsal muscle is innervated by fibers traveling through the cervical sympathetic trunk and the internal carotid
plexus.
If the trunk is interrupted, the muscle is paralyzed, causing drooping of the eyelid (ptosis). This is one of the signs of cervical
sympathetic trunk injury.
The affected pupil is smaller than the pupil of the opposite eye. It does not dilate when the pupil is shaded (miosis).
(157).
63/119
(158).
(159).
(160).
A 75-year-old man develops unilateral, painless loss of vision associated with pallor of the optic disc, a cherry-red fovea, and
bloodless arterioles. These findings are most consistent with which of the following?
a. Central retinal vein occulusion
b. Acute glaucoma
c. Acute anterior uveitis
d. Central retinal artery occlusion
Solution. : (d)Central retinal artery occlusion
Reference Read the text below
Sol:
The patient has central retinal artery occlusion. This is characterized by a sudden, complete, painless loss of vision in one eye,
most commonly n an elderly patient.
Retinal examination reveals pallor of the optic disc; edema of the retina; a cherry-red fovea;bloodless, constricted
arterioles; and a boxcar segmentation of blood in the retinal veins.
Surgical decompression of the anterior chamber in less than 1 hourafter occlusion prevents permanent damage to the eye.
Your Answer. d
Correct Answer. d
64/119
(161).
(162).
65/119
(163).
Which of the following is an inert metal that can be left alone in eye?
a. Iron
b. Copper
c. Lead
d. Nickel
Solution. (c) Lead
Ref.:Read the text below
Sol :
INTRAOCULAR FOREIGN BODIES
They can be classified into the following types.
Frequently produce severe inflammatory reactions
Magnetic : Iron, steel, tin
Non magnetic : Copper and vegetable matter
Typically produce mild inflammatory reactions
Magnetic : Nickel
Nonmagnetic : Aluminium, mercury, zinc, vegetable matter.
Inert foreign bodies
Carbon, coal, glass, gold, lead, stone
Your Answer. d
Correct Answer. c
(164).
66/119
(165).
A 73-year-old man with a history of hypertension complains of a 10-min episode of left-sided weakness and slurred speech. On
further questioning, he relates three brief episodes in the last month of sudden impairment of vision affecting the right eye. His
examination now is normal.The episodes of visual loss are most likely related to
a. Retinal vein thrombosis
b. Central retinal artery ischemia
c. Posterior cerebral artery ischemia
d. Middle cerebral artery ischemia
Solution. (b)Central retinal artery ischemia
Reference Read the text below
Sol:
The presumed mechanism of transient monocular blindness in carotid artery disease is embolism to the central retinal
artery or one of its branches.
Although classic teaching has emphasized the role that cholesterol emboli play in causing this blindness, it has been noted that
cholesterol emboli (Hollenhorst plaques) may be seen on fundoscopic examination even of asymptomatic individuals.
Retinal vein thrombosismay produce a rapidly progressive loss of vision with hemorrhages in the retina, but would not be
associated with the TIAs described here.
Although both posterior and middle cerebral artery ischemia can cause visual loss, they would not be expected to cause the
monocular blindness described here.
Posterior ciliary artery ischemiacan cause ischemic optic neuropathy, but this is usually acute, painless, and not associated with
preceding transient monocular blindness or TIAs.
Your Answer. a
Correct Answer. b
(166).
Normally, the only conducting pathway between atria and ventricles is the AV node. In individuals with WPW syndrome, there is an
aberrant muscular or nodal tissue connection (Bundle of Kent) between atria and ventricles.
The aberrant pathway either connects left atrium with left ventricle or right atrium with right ventricle.
Bundle of Kent conducts more rapidly than the slowly conducting AV node and thus, one of the ventricles is excited early.
Your Answer. b
Correct Answer. b
(167).
67/119
(168).
Tumor infiltration especially carcinoma in gastric fundus is the most common malignant cause of achalasia.
Your Answer. b
Correct Answer. c
(169).
Type of peptic ulcer associated with highest recurrence rate following proximal gastric vagotomy is:
a. Post-pyloric ulcer
b. Pre-pyloric ulcer
c. Intra-pyloric ulcer
d. Post-bulbar ulcer
Solution. (b) Pre-pyloric ulcer
Ref Read the text below
Sol:
Highly selective vagotomy is procedure of choice in elective surgery except in situation where ulcer recurrence rates are high.
Your Answer. b
Correct Answer. b
(170).
According to JRSGC, the morphological classification of EGC, an excavated lesion involving mucosa and submucosa belong to:
a. Type I
b. Type II
c. Type III
d. Type IV
Solution. (c) Type III
Ref Read the text below
Sol:
68/119
(171).
DLCO is a very sensitive test for interstitial lung diseases, in which it is decreased. Which among the following conditions cause
an increase in DLCO?
a. Pulmonary fibrosis
b. Pulmonary artery hypertension
c. Alveolar hemorrhage
d. ILD
Solution. (c) Alveolar hemorrhage
Ref Read the text below
Sol:
DLCO :
Diffusion capacity (or Transfer factor) of lung Carbon monoxide
Normal in asthma
(172).
Pepsin
NSAIDs
N-Acetyl cysteine
Your Answer. d
Correct Answer. a
(173).
The BODE index, a simple multidimensional grading system, is better than the FEV 1 at predicting the risk of death from any cause
and from respiratory causes among patients with COPD.Which of the following is not the component of BODE index?
a. BMI
b. Oxygen requirement
c. Dyspnoea
d. Exercise performance
Solution. (b) Oxygen requirement
Ref Read the text below
Sol:
BODE index includes
1. BMI
2. Airflow Obstruction
3. Dyspnoea
4. Exercise performance
Your Answer. c
Correct Answer. b
69/119
(174).
This condition is related to reduce postoperative acid secretion and a decreased ability to dissociate ferric iron from food.
Folate and vitamin B12 deficiencies can also develops in these patients, but these deficiencies are much less common.
Your Answer. b
Correct Answer. a
(175).
Poor surgical candidatesand patients with a negative result from a gastrografin swallow can be managed conservatively if there
are no sign of generalized peritonitis.
There is no evidence suggesting that octreotide is of any benefit in the management of these cases.
Your Answer. d
Correct Answer. d
(176).
70/119
(177).
(178).
(179).
71/119
(180).
Peritonitis in adults is :
a. E. Coli
b. Staph. Aureus
c. Strep. Viridians
d. Enterococcus
Solution. (a) E. Coli
Ref.:Read the text below
Sol :
Spontaneous Bacterial Peritonitis (SBP)
Common and severe complication of ascites characterized by spontaneous infection of ascetic fluid without an intraabdominal source.
Can occur in upto 30% of individuals with cirrhosis and ascites severe enough for hospitalization
Mechanism Bacterial translocation with gut flora traversing the intestine into mesenteric lymph nodes leading to bacteremia and
seeding into ascetic fluid.
Most common organism implicated is E. Coli
Your Answer. a
Correct Answer. a
(181).
(182).
72/119
(183).
Which of the following tests is most sensitive for detecting early diabetic nephropathy?
a. Serum creatinines
b. Creatinine clearance
c. Microalbuminuria
d. Ultra sonography
Solution. (c) Microalbuminuria
Ref: Read the text below
Sol :
The first clinically detectable sign of diabetic nephropathy is microalbuminuria.
The most sensitive method to detect microalbuminuria is by radioimmunoassay
The renal biopsy is the only test of the effect of diabetes on the kidney that is more sensitive than microalbuminuria.
Your Answer. c
Correct Answer. c
(184).
(185).
Regimen II a
Your Answer. c
Correct Answer. d
73/119
(186).
(187).
74/119
(188).
1st week
Both blood culture and bone marrow culture show high sensitivity, however, blood cultures are affected by
prior intake of antibiotics, but bone marrow cultures are more specific and sensitive and not affected by
antibiotics, hence making them a better diagnostic test than blood culture in first week of typhoid infection.
Sensitivity of blood culture : 60-90%
Sensitivity of bone marrow culture : >95%
2nd week
Widal test
Your Answer. a
Correct Answer. b
(189).
75/119
(190).
(191).
infection with?
a. Proteus
b. E coli
c. Pseudomonas
d. Klebsiella
Solution. (a) Proteus
Ref.:Read the text below
Sol :
Xanthogranulomatous pyelonephritis is a chronic condition of the kidney resulting in diffuse renal destruction, a grossly
enlarged and nonfunctioning kidney associated with nephrolithiasis.
It is thought to start with obstruction (stone or sloughed papilla) followed by infection (most commonly proteus)
Your Answer. c
Correct Answer. a
(192).
76/119
(193).
Distal gastrectomy without vagotomy has traditionally been the procedure of choice for: a. Type I gastric ulcer.
b. Type II gastric ulcer.
c. Type III gastric ulcer.
d. Hiatal hernia
Solution. (a) Type I gastric ulcer.
Ref: Sch8- 962-963.
Sol:
Distal Gastrectomy
Distal gastrectomy without vagotomy (usually about a 50% gastrectomy to include the ulcer) has traditionally been the
procedure of choice for type I gastric ulcer.
(194).
Bleeding gastric ulcers tend to occur in older and/or medically complicated patients, and this fact tends to increase the
operativerisk.
Patients with gastric ulcer bleeding who are most likely to require surgery have bled more than 6 units and have presented in
shock.
Endoscopically, their ulcers tend to be on the lesser curvature with the usual stigmata of recent hemorrhage.
Distal gastric resection to include the bleeding ulcer is the procedure of choice for bleeding gastric ulcer.
Second best is vagotomy and drainage with oversewingand biopsy of the ulcer.
Your Answer. d
Correct Answer. a
77/119
(195).
A 50- to 100-cm common absorptive alimentary channel is created proximal to the ileocecal valve; digestion and absorption are
limited to this segment of bowel.
Indications
This procedure is primarily indicated for the superobese or for those who have failed restrictive bariatric procedures.
Contraindications
Patients with anemia, hypocalcemia, and osteoporosis, and those who are not motivated to comply with stringent postoperative
supplementation regimens may not be appropriate for this procedure.
Complications
The most common morbidities include anemia (30%), protein-calorie malnutrition (20%), dumping syndrome,and marginal
ulceration (10%).
The duodenal switch modification is associated with a lower ulceration rate (1%) and a lower incidence of dumping
syndrome.
Other complications include vitamin B12deficiency, hypocalcemia, fat-soluble vitamin deficiencies, osteoporosis,night blindness, and
prolongation of prothrombin time.
Your Answer. b
Correct Answer. a
(196).
Campylobacters are motile, curved, oxidase-positive, Gram-negative rods similar in morphology to vibrios.
The cells have polar flagella and are often are attached at their ends giving pairs S shapes or a seagull appearance.
C. jejuni grows well only on enriched media under microaerophilic conditions. That is, it requires oxygen at reduced tension (5
10%), presumably due to vulnerability of some of its enzyme systems to superoxides.
C. jejuni has the structural components found in other Gram-negative bacteria (eg, outer membrane,LPS).
In contrast to the vibrios, it does not break down carbohydrates, but uses amino acids and metabolic intermediates for energy.
Your Answer. c
Correct Answer. d
78/119
(197).
Which of the following conditions are associated with the development of esophageal carcinoma?
a. Caustic esophageal stricture
b. Achalasia of the esophagus
c. Plummer-Vinson syndrome
d. All of above.
Solution. (d) All of above.
Ref - Read the text below
Sol:
Chronic irritation of the esophageal mucosa by a variety of noxious stimuli (alcohol, tobacco, hot foods and liquids) eventually
may lead to the development of esophageal carcinoma.
The patient who survives the initial injury long enough to develop a caustic esophageal stricture has a 1000-fold increased
risk of developing carcinoma compared with the normal population. Ten to 12% of patients with achalasia of the esophagus
who are observed 15 years or more develop esophageal carcinoma.
This is thought to be related to the irritating effects of the fermenting intraesophageal contents on the adjacent esophageal mucosa.
Plummer-Vinson syndrome is a premalignant esophageal condition. Patients with this syndrome are typically elderly women
who have cervical dysphasia and iron deficiency anemia.
About 10% of patients will develop squamous cell carcinoma of the hypopharynx, oral cavity or esophagus. Finally, there have been
isolated reports of esophageal carcinomas found incidentally within esophageal diverticula, presumably as the result of the irritating
effects on the mucosa of stagnant, putrefying food within the pouch.
Esophageal diverticula are therefore regarded as premalignant esophageal lesions although this occurrence is extremely
rare.
Your Answer. d
Correct Answer. d
(198).
Klinefelter syndrome
Other possible causes include exposure to certain chemicals and HIVinfection. A family history of testicular cancer may also
increase risk.
Testicular cancer is the most common form of cancer in men between the ages of 15 and 35. It can occur in older men, and
rarely, in younger boys.
Your Answer. b
Correct Answer. b
79/119
(199).
The first investigation of choice in a patient with suspected subarachnoid haemorrhage should be:
a. Non-contrast computed tomography
b. CSF examination.
c. Magnetic resonance imaging (MRI).
d. Contrast-enhanced computed tomography.
Solution. (a) Non-contrast computed tomography
Ref: Read the text below.
Sol:
Intracranial hemorrhage is often discovered on non contrast CT imaging of the brain during the acute evaluation of stroke.
CT is more sensitive than routine MRI for acute blood. The location of hemorrhage narrows the differential diagnosis to a few
entities.
Your Answer. b
Correct Answer. a
(200).
(201).
Variety
Treatment
Your Answer. d
Correct Answer. b
80/119
(202).
An air fluid level with dilated oesophagus and bird beak appearance in a barium swallow is diagnostic of which one of the
following ?
a. Achalasia cardia
b. Carcinoma oesophagus
c. Hiatus hernia
d. Barretts oesophagus
Solution. (a) Achalasia cardia
Ref: Bailey and Loves short Practice of Surgery- 883,
Sol :
Radiological features
Examples
Achalasia cardia
Curling esophagus
Your Answer. b
Correct Answer. a
(203).
81/119
(204).
(205).
82/119
(206).
(207).
(208).
83/119
(209).
(210).
(211).
84/119
(212).
(213).
(214).
85/119
(215).
(216).
(217).
86/119
(218).
The majority of cases are benigngestational thrombocytopenias, but the differential diagnosis should include immune
thrombocytopenia and preeclampsia.
Maternal thrombocytopenia may also be caused by catastrophic obstetric events such as retention of a dead fetus, sepsis,
abruption placenta, and amniotic fluid embolism.
Your Answer. a
Correct Answer. a
(219).
18 year old girl presentswith amenorrhea, anorexia, weight loss and with milk discharge from the nipples. What is thelikely
diagnosis?
a. . HIV
b. Occult carcinoma
c. Anorexia nervosa
d. Hypothyroidism
Solution. (c) Anorexia nervosa
Ref:Read the text below
Sol:
In the above options, hypothyroidism is ruled out as it leads on to weight gain and menorrhagia commonly, though
galactorrhoea can be present.
Though HIV can be associated with anorexia and weight loss,Harrison says, HIV does not seem to have a significant effect on
menstrual cycle outside setting of advanced disease.
Also, galactorrhoea has not been mentioned as a consequence of HIV anywhere. Occult carcinoma, can cause anorexia and
weight loss.
Your Answer. b
Correct Answer. c
(220).
87/119
(221).
The ideal treatment for metastatic choriocarcinoma in the lungs in a young women is :
a. Chemotherapy
b. Surgery with radiation
c. Surgery
d. Wait and watch
Solution. (a) Chemotherapy
Ref.:Shaws - 258
Sol :
Since gestational choriocarcinoma(which arises from a hydatidiform mole) contains paternal DNA (and thus paternal antigens), it is
exquisitely sensitive to chemotherapy. The cure rate, even for metastatic gestational choriocarcinoma, is around 90-95%.
At present, treatment with single-agent methotrexateis recommended for low-risk disease, while intense combination regimens including
EMACO (etoposide, methotrexate, actinomycin D, cyclosphosphamideand vincristine(Oncovin) are recommended for intermediate or
high-risk disease.
Your Answer. a
Correct Answer. a
(222).
88/119
(223).
Antiprogesterone compound RU-486 if effective for inducing abortion if the duration of pregnancy is:
a. 63 days
b. 72 days
c. 88 days
d. 120 days
Solution. (a) 63 days
Ref:Read the text below
Sol:
RU-486 i.e. Mifepristone, is an analogue of the progestin norethindrone which has strong affinity for progesterone receptors
but acts as an antagonist of progesterone.
Given alone, the during was moderately useful in causing abortion of early pregnancy, however the combination of mifepristone
with analogue of prostaglandin E, i.e. misoprostol is very effective.
Your Answer. d
Correct Answer. a
(224).
In a 30-year-old patient presenting at 38 weeks gestation with increased reflexes and hypertension and pedal edema all of the
following can be seen except:
a. SGOT/SGPT increased
b. Increased platelets
c. Increased uric acid levels
d. Increased creatine levels
Solution. (b) Increased platelets
Ref.:Read the text below
Sol :
Variable
Diastolic blood pressure
Convulsions
Blindness
Headaches
Visual symptoms
Oliguria
Upper abdominal pain
Fetal distress
Fetal growth retardation
Intravascular hemolysis
Thrombocytopenia
Blood urea nitrogen (BUN) creatinine, uric acid
levels
Sercum glutamicoxaloacetic transaminase (SGOT),
serum glutamic pyruvic transaminase (SGPT),
lactate dehydrogenase (LDH)
Mild
90-10 mmH
Absent
Absent
Minimal
Minimal
Absent
Absent
Absent
Absent
Absent
Absent
Normal
Normal
Moderate
Severe
100-110 mmHg
Absent
Absent
Mild
Mild
Absent
Absent
Absent
Absent
Absent
Absent
Mildly elevated
Mildly elevated
Markedly elevated
Your Answer. b
Correct Answer. b
89/119
(225).
(226).
(227).
Among 100 healthy, fertile couples, approximately how many will become pregnant within 1 month if they have regular intercourse?
a. 15
b. 20
c. 35
d. 45
Solution. (b) 20
Ref:Read the text below
Sol:
90/119
(228).
A 24-year-old woman, gravida 3, para 1, spontaneous abortions 1, presents with irregular vaginal bleeding. She is found to be
pregnant and her serum hCG is 3500 mIU/mL. She has a past medical history significant for diabetes mellitus and mild asthma.
Her BP = 103/68, P = 88, and T = 98.8. Transvaginal ultrasound reveals a uterus with no gestational sac present and a 2-cm right
adnexal mass. The least invasive treatment of choice is:
a. Expectant management
b. Methotrexate
c. Laparoscopic salpingostomy
d. Laparoscopic salpingectomy
Solution. (b) Methotrexate
Ref:Read the text below
Sol:
This patient has an ectopic pregnancy that is amenable to treatment with methotrexate because she has no contraindications
(hCG not high, less than 3-cm adnexal mass, and mild asthma and diabetes mellitus are not contraindications).
Although methotrexate and linear salpingosto-my have comparable rates of tubal patency and fertility, methotrexate is the least
invasive.
Expectant management of a growing ectopic pregnancy is not appropriate given possibility of rupture and hemorrhage, which can
be catastrophic.
Salpingectomy is not preferred to salpingostomy in someone who desires future fertility. Laparotomy is not indicated in this
patient, who is hemodynamically stable.
Your Answer. b
Correct Answer. b
(229).
Periconceptional use of the following agent leads to reduced incidence of neural tube defects:
a. Folic acid
b. Iron
c. Calcium
d. Vitamin A
Solution. (a) Folic acid
Ref:Read the text below
Sol:
Folic acid has been shown to effectively reduce the risk of neural tube defects (NTDs) A daily 4 mg dose is recommended for
patients who have had a previous pregnancy affected by neural tube defects.
It should be started at least 1 month (ideally 3 months) prior to pregnancy and continued through the first 6-12 weeks of
pregnancy.
Your Answer. a
Correct Answer. a
(230).
Time taken
0.002
0.05mlU/ml
Positive on
3-4 hours
30 min.
conception
Your Answer. b
Correct Answer. d
91/119
(231).
Denominator is
a. Relation of the different parts of the fetus with one another
b. Part of the presentation which oversees the internal OS
c. Boney fixed point on the presenting part
d. Part of the fetus that occupies the lower pole of the uterus
Solution. (c) Boney fixed point on the presenting part
Ref.:Read the text below
Sol :
Denominator is an arbitrary bony fixed point on the presenting part which comes in relation with the various quadrants of the maternal
pelvis.
The following are the denominators of the different presentations.
Occiput in vertex.
Mentum in face.
Frontal eminence in brow.
Sacrum in breech, and
Acromion in shoulder.
Your Answer. c
Correct Answer. c
(232).
92/119
(233).
All of the following are used in the treatment of postpartum hemorrhage except:
a. .Misoprostol
b. Mifepristone
c. Carboprost
d. Methyl ergometrine
Solution. (b) Mifepristone
Ref.:Dutta Obs. - 416
Sol :
Medical Management : Drugs used for management of PPH are :
Oxytocin
Ergometrine or methergine(care should be taken in hypertensive patients).
15 methyl PGF 2 : can be given both I/M and intramurally into the uterine musculature and prepeated after 15 mins, for a maximum
of 3 doses.
Prostaglandins may cause diarrhoea, vomiting, tachycardia and pyrexia. PGF-2 can also produce severe bronchospasm
(Contraindicated in asthmatic patients).
Misoprostol (PGE1)can be inserted rectally or vaginally upto a maximum of 1000ug.)
Your Answer. b
Correct Answer. b
(234).
A case of 35 week pregnancy with hydramnios and marked respiratory distress is best treated by :
a. Intravenous frusemide
b. Saline infusion
c. Amniocentesis
d. Artificial rupture of membranes
Solution. (c) Amniocentesis
Ref.:Dutta Obs 6/e, p 216
Sol :
The patient has marked respiratory distress (i.e. it is a severe polyhydramnios and requires treatment) and gestational age is 35
weeks (i.e., fetal maturity is not yet achieved).
So our aim should be to relieve the distress of patient in hope of continuing the pregnancy till at least 37 weeks.
This can be achieved by : Amniocentesis or Use of Indomethacin
Amniocentesis
The main aim of amniocentesis is to relieve maternal distress with the added advantage that lung maturity of fetus can be predicted by
Lecithin/Sphingomyelin ratio in the expressed fluid.
Slow decompression is done at the rate of 500 ml/hr.
Maximum fluid removed is 1.5 2 litres.
Your Answer. d
Correct Answer. c
93/119
(235).
(236).
CA 125
Mucinous cystadenoma
CEA, CA 19-9
AFP, Alpha 1
HCG, AFP
Choriocarcinoma
HCG
Dysgerminoma
Inhibin
Your Answer. a
Correct Answer. d
94/119
(237).
(238).
Unequal sizes of twin fetuses with a difference of 25% (larger twin being used as the index) is called as Discordant growth.
(239).
It is the fertilization of two different ova released in the same cycle, by separate acts of coitus within a short period of time.
Superfetation
It is the fertilization of two ova released in different menstrual cycles. This is theoretically possible until the decidual space is
obliterated by 12 weeks of pregnancy.
Your Answer. b
Correct Answer. a
95/119
(240).
(241).
(242).
96/119
(243).
In the developed countries, cystic fibrosis is the most common etiology of pancreatic insufficiency.
This is present in more than 90% of children with cystic fibrosis and is usually present at birth.
(244).
A 15-month-old child presents with a high fever, and an intense, red rash on the cheeks with circumoral pallor. What is the most
likely etiology of this febrile exanthem?
a. Enterovirus 71
b. Adenovirus
c. Parvovirus B19
d. Rubeola Virus
Solution. (c) Parvovirus B19
Ref: Read the text below
Sol:
The clinical manifestations of human parvovirus B-19 include erythema infectiosum (healthy child), polyarthropathy syndrome
(adults especially women), chronic anemia/pure red cell aplasia (immunocompromised hosts), transient aplastic crisis (sickle cell
patients), and hydrops fetalis/congenital anemia (fetus). Erythema infectiosum is most commonly diagnosed and easily
recognized.
Adistinctive rash featuring a slapped cheek appearance is noted that is often associated with circumoral pallor.
Enterovirus 71 is also associated with encephalitis. Adenovirus is not associated with a characteristic exanthem, however it may
cause conjunctivitis.
Rubeola virus is the causativeagent of measles, and generally presents with a triad of cough, coryza, and conjunctivitis, as well as
Koplik spots and rash.
Your Answer. c
Correct Answer. c
(245).
A term female is born by spontaneous vaginal delivery to a primiparous woman who received two doses of meperidine 30 min
and 2 hr prior to an abrupt delivery. The baby is apneic and limp. The most important, immediate management is to:
a. Administer naloxone in the umbilical vein
b. Perform bag-mask ventilation
c. Administer naloxone in the endotracheal tube
d. Begin chest compressions
Solution. (b) Perform bag-mask ventilation
Ref: Read the text below
Sol:
Apnea from any cause is treated with securing a patent airway and instituting ventilation.
97/119
(246).
(247).
(248).
A 5-yr-old girl is evaluated forsevere mental retardation, microcephaly, hand-wringing movements, poor growth and weight
gain, and seizures. Genetic analysis indicates a mutation in a transcription factor called MeCP2 that normally functions to
silence transcription of numerous genes. This finding indicates that she has which of the following disorders?
a. Juvenile Huntington disease
b. Metachromatic leukodystrophy
c. Rett syndrome
d. Adrenoleukodystrophy
Solution. (c) Rett syndrome
Ref: Read the text below
Sol :
Rett syndrome is a neurodevelopmental disorderof the grey matter of the brain that almost exclusively affects females.
The clinical features include small hands and feet and a deceleration of the rate of head growth (including microcephaly in
some).
Repetitive hand movements, such as wringing and/or repeatedly putting hands into the mouth, are also noted. People with Rett
syndrome are prone to gastrointestinal disorders and up to 80% have seizures.
They typically have no verbal skills, and about 50% ofindividuals affected are not ambulatory. Scoliosis, growth failure, and
constipation are very common and can be problematic.
Your Answer. c
Correct Answer. c
98/119
(249).
Steroid Resistant Nephrotic syndrome is associated with which of the following gene:
a. NPHSI
b. PAX
c. HOX II
d. NPHS2
Solution. (d) NPHS2
Ref:Read the text below
Sol :
Your Answer. b
Correct Answer. d
(250).
A 5-mo-old infant with gross motor delay, hypotonia, and cardiomegaly has a creatine kinase level of 860 IU/L. Of the
following, which is the most likely diagnosis?
a. Spinal muscular atrophy
b. Hypothyroidism
c. Prader-Willi syndrome
d. Pompe disease
Solution. (d) Pompe disease
Ref:Read the text below
Sol :
Pompe disease, also referred to as GSD type II oracid maltase deficiency, is caused by a deficiency of acid -1,4-glucosidase
(acid maltase), an enzyme responsible for the degradation of glycogen in lysosomes.
This enzyme defect results in lysosomal glycogenaccumulation in multiple tissues and cell types, with cardiac, skeletal, and
smooth muscle cells being the most seriously affected. The disease is characterized by accumulation of glycogen in lysosomes, as
opposed to its accumulation in cytoplasm in the other glycogenoses.
Pompe disease is an autosomal recessive disorder. Clinical trials of enzyme replacement therapy (ERT) have been
promising and ERT withmyozyme is available for treatment of Pompe disease. Recombinant acid -glucosidase is capable of improving
cardiac and skeletal muscle functions
Your Answer. d
Correct Answer. d
99/119
(251).
(252).
In a neonate with the skin of soles and palms showing yellow discoloration, the approximate level of serum bilirubin (mg/dl)
will be :
a. 4-8 mg/dL
b. 8-16 mg/dl
c. 11-18 mg/dL
d. > 15 mg/dL
Solution. (d) > 15 mg/dL
Ref.:Read the text below
Sol :
Area Yellow discoloration of body in jaundice Range of serum bilirubin (mg%)
Head and neck
48
Upper trunk
5- 12
8 16
11- 18
More than 15
Your Answer. d
Correct Answer. d
100/119
(253).
Which rule is for estimation of child age from the crown rump length?
a. Haase rule
b. Mc Naghtens rule
c. Locards principle
d. Durhams rule
Solution. (a) Haase rule
Ref.:Read the text below
Sol :
Haases rule is for calculating the age of fetus from its length in cm.
1st 5 lunar months = square of length in cm.
2nd 5 lunar months = length in cm/5.
Your Answer. d
Correct Answer. a
(254).
A 3 year old child presents with recurrent stridor, what is the most probable diagnosis?
a. Laryngomalacia
b. Laryngotracheobronchitis
c. Foreign body aspiration
d. Laryngeal edema
Solution. : (b) Laryngotracheobronchitis
Ref.:Read the text below
Sol :
Most common cause of stridoroverall is laryngotracheobronchitis
Most common cause of stridor in children is laryngotracheobronchitis
Most common of congenital stridor is laryngomalacia
Most common cause of stridor in newborn is laryngomalacia
Your Answer. b
Correct Answer. b
(255).
A 45 day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to
be positive for HbsAg. The mother was also HBsAg carrier. The mothers hepatitis B serological profile is likely to be
a. HBsAg positive only
b. HBsAg and HBeAg positivity
c. HBsAg and anti HBe antibody positivity.
d. Mother infected with mutant HBV
Solution. (b) HBsAg and HBeAg positivity
Ref.:Read the text below
Sol :
Vertical transmissiondepends upon the maternal HBeAg status.
HBsAg carrier mother who are HBeAg positive almost invariably (>90%) transmit hepatitis B, infection to their off springs where as
HBsAg carrier mother with anti HBe rarely (10-15%) infect their offsprings.
Your Answer. b
Correct Answer. b
101/119
(256).
(257).
(258).
102/119
(259).
All of the following are essential features of attention deficit hyperactivity disease (ADHD) except :
a. Lack of concentration
b. Impulsivity
c. Mental retardation
d. Hyperactivity
Solution. (c) Mental retardation
Ref.:Read the text below
Sol :
Inattention, hyperactivity, disruptive behavior and impulsivity are common in ADHD.
The symptoms are especially difficult to define because it is hard to draw a line at where normal levels of inattention, hyperactivity,
and impulsivity end and clinically significant levels requiring intervention begin.
To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that
is greater than other children of the same age
Your Answer. c
Correct Answer. c
(260).
True isomorphism (Koebners) is seen in vitiligo, psoriasis and lichen planus while pseudo isomorphism is seen in
autoinoculation in warts and molluscum contagiosum.
Your Answer. d
Correct Answer. d
(261).
Most superficial type produces crystalline miliaria while mid level block produces miliaria rubra (prickly heat) and deep blocks
produce miliaria profunda.
Sebaceous glandsare always associated with hair follicles except free/ectopic glands like Fordyce disease or granules.
Eccrine sweatglands of palms and soles differ from other glands by responding to emotional stimuli too.
Your Answer. d
Correct Answer. a
103/119
(262).
Fish tank granuloma and swimming pool granuloma are cutaneous atypical mycobacteriosis caused by M. marinum.
(263).
Impetigo herpetiformis is pustular psoriasis of pregnancy and pyoderma gangrenosum is a neutrophilic ulceration associated with
ulcerative colitis etc.
(264).
104/119
(265).
Plaque psoriasisshould be treated with topical steroids if limited, phototherapy if moderate and methotrexate or retinoids if
extensive.
But in pregnancy if pustular psoriasis is severe (impetigo herpetiformis) it is treated with oral steroids.
Pemphigus vulgaris, type I lepra reaction are also treated with oral steroids
Your Answer. d
Correct Answer. d
(266).
(267).
Treatment of reactional neuritis in the acute phase of Type I lepra reaction involves:
a. Active exercises
b. Passive exercises
c. Rest of the affected limb in neutral position
d. Surgical exploration
Solution. (c) Rest of the affected limb in neutral position
Ref:Read the text below
Sol :
Acute neuritis requires, resting of the affected limb, oral steroids and continued MDT.
Your Answer. b
Correct Answer. c
105/119
(268).
Sulfites are found in wine, dried fruit, prepared foods, and fresh grapes and potatoes.
Ciguatera or scombroid fish poisoningis a form of histamine-related food poisoning, caused by histamine within the flesh of the
fish
Your Answer. a
Correct Answer. d
(269).
Keratoconus
Accessory and deep infraorbital lines (Dennies lines/ Dennie Morgan folds).
Your Answer. a
Correct Answer. a
(270).
Opioid effects on respiratory rate and rhythminclude all the following except
a. Decreased respiratory rate
b. Irregular respiratory rate
c. Cheyne-Stokes breathing patterns
d. Increased respiratory pauses
Solution. (c) Cheyne-Stokes breathing patterms
Ref:Read the text below.
Sol:
A Cheyne-Stokes respiratory pattern consists of periods of increasing hyperventilation alternating with apnea. The rate of
ventilation increases markedly and then declines until apnea occurs.
This pattern repeats in a rhythmic fashion.
Cheyne-Stokes respiration usually occurs after a cerebral anoxic event and reflects brain damage. Opioids do not cause this respiratory
pattern.
Your Answer. d
Correct Answer. c
106/119
(271).
(272).
Patients, especially infants or young children, with recurrent respiratory symptoms such as chronic cough, stridor and wheeze,
should be examined for the possible presence of congenital vascular rings.
Contrast-enhanced CT can clearly show the anatomy of vascular rings. Contrast-enhanced thoracic CT with 3D reconstruction may
allow accurate diagnosis and clearly show compression of the tracheoesophageal tract.
For several decades, the diagnosis of vascularrings has mainly relied on chest X-rays and barium swallow. Recently, it has been
shown that CT had replaced barium swallow as the diagnostic procedure of choice for vascular ring evaluation.
Although angiography has been used to further delineate arch anatomy, it is now rarely performed due to the availability of
noninvasive techniques and due to problems like overlapping of structures.
Your Answer. b
Correct Answer. b
(273).
LC occurs in an estimated 20% of patients diagnosed with cancer and is most commonly found in breast carcinoma, lung carcinoma,
and melanoma in adults and hematogenous malignancies and primitive neuroectodermal tumor (PNET) in children.
Contrast-enhanced MRI of the brain and spine is the imaging modalityof choice because of its safety, excellent contrast
resolution, and multiplanar abilities.
Your Answer. a
Correct Answer. a
107/119
(274).
2.
Your Answer. b
Correct Answer. b
(275).
A 37-year-old woman complains of headache and blurry vision that have been present for a year and are slowly getting worse.
As part of her evaluation an MRI is obtained and shown below:
What is the most likely diagnosis in this patient?
a. Brain abscess
b. Glioblastoma
c. Low-grade astrocytoma
d. Meningioma
Solution. (d) Meningioma
Ref: Read the text below
Sol:
This figure illustrates a mass attached to the meninges with a dural tail. Other dural tumors may appear this way, but of the
options listed, the meningioma is by far the most likely to appear this way.
Meningiomas derive from the cells that give rise to the arachnoid granulations. They are usually benign and attached to the dura.
They rarely invade the brain.
They are more frequent in women than men and have a peak incidence in middle age. Total surgical resection of a
meningioma is curative. Low-gradeastrocytoma and high-grade astrocytoma (glioblastoma) often infiltrate into adjacent brain and
rarely have the clear margins seen in this figure.
Oligodendroma comprise ~15% of all gliomas and show calcificationin roughly 30% of cases. They have a more benign course
and are more responsive than other gliomas to cytotoxic therapy.
For low-grade oligodendromas, the median survival is 78 years. Brain abscess will have distinctive ring-enhancing features
with a capsule, often have mass effect, and will have evidence of inflammation on MRI scanning.
Your Answer. d
Correct Answer. d
108/119
(276).
Ultrasonography can be detect the IUCD eitherwithin the uterine cavity or in the peritoneal cavity (if perforated).
It is preferred over radiography.
Your Answer. b
Correct Answer. b
(277).
Mammographic evaluation of the augmented breasts (i.e. breasts with silicon implant) is challenging, since breast implants
obscure significant part of breast tissue & also reduce the effect of compression.
(278).
Radiation exposureduring infancy has been linked to which one of the following carcinomas?
a. Breast
b. Melanoma
c. Thyroid
d. Lung
Solution. (c) Thyroid
Reference: (Ref. Radioactive Isotopes in Medicine and Biology, 2nd ed., 135)
Sol:
Secondary cancersare the cancers which occur due to exposure to radiation. Ca thyroid (papillary type) is a classical example.
A number of cases of cancer of thyroid have been reported in children who had some years previously received X-ray treatment for
disorders like thymus enlargement, infected tonsils, etc. these treatments were given in early infancy.
However, it has now been practically discontinued. However, radiation exposure during childhood, especially infancy, for some reason or
other has been linked to further risk of development of thyroid cancer.
Your Answer. c
Correct Answer. c
109/119
(279).
The classic arachnoid cyst has no identifiable internal architecture and does not enhance. The cyst typically has the same
signal intensity as CSF at all sequences. The most difficult lesion to distinguish from the arachnoid cyst is an epidermoid cyst. Arachnoid
cysts typically suppress completely on FLAIR images and do not restrict on diffusion-weighted images. Arachnoid cysts displace
adjacent arteries and cranial nerves rather than engulf them, as epidermoid cysts often do.
Proton density-weighted and then fluid-attenuated inversionrecovery (FLAIR) images were first used to differentiate epidermoids
from arachnoid cysts. These sequences demonstrate epidermoids as being hyperintense relative to CSF. Diffusion-weighted imaging can
now be used to differentiate these entities, because epidermoids have markedly restricted diffusion and, therefore, high signal intensity
on the diffusion-weighted trace images. The free water in arachnoid cysts has low signal intensity.
Your Answer. d
Correct Answer. d
(280).
(281).
He was first to unchain mental patients, prior to him, psychiatric patients were like animals kept caged in a zoo.
Your Answer. a
Correct Answer. d
110/119
(282).
ICD-10 having 21 chapters was endorsed by the Forty-third World Health Assembly in May 1990 and came into use in WHO Member
States as from 1994.
The 11th revision of the classification has already started and will continue until 2017.
Your Answer. c
Correct Answer. c
(283).
111/119
(284).
An adoloscent whose chronological age was 18y, mental age was corresponding to 12y, ; according to binet formula for I.Q.
calculation, he should be (as per DSM-IV TR grading)
a. Mild mental retarded
b. Moderate mental retarded
c. Borderline intelligence
d. Dull Normal intelligence
Solution. (d) Dull Normal intelligence
Ref:Read the text below
Sol :
There is a catch here. You all know how to calculate I.Q.
But answer is not 66.6 I.Q. (Mild)
Pg 178 kaplan states : (Because it is impossible to measure age-associated changes in intellectual power after the age of 15 with
available intelligence tests, the highest divisor in the IQ formula is 15.)
So, for this case
I.Q. is 12/15 * 100 = 80.
Remember, DSM IV grading:
Profound mental retard(MR)
Below 20 or 25
Severe MR
20-25 to 35-40
Moderate MR
35-40 to 50-55
Mild MR
50-55 to about 70
Borderline
70-79
Dull normal
80 to 90
Normal
90 to 110
Bright normal
110 to 120
Superior
120 to 130
Very superior
Your Answer. b
Correct Answer. d
(285).
8 yr old student c/o no interest in studies 4 last 6 months , has frequent quarrels with parents and has frequent headaches. Most
appropriate clinical approach is:
a. Leave as normal adolescent problem
b. Rule out depression
c. Rule out migraine
d. Rule out oppositional defiant disorder
Solution. (b) Rule out depression
Ref:Read the text below
Sol :
Irritability & somatic complaints (headache) along with school refusal (decreased interest in studies) are very commonly seen
in childhood depression...
112/119
(286).
Patients with anorexia nervosa exhibit peculiar behavior about food. They hide food all over the house and frequently carry large
quantities of candies in their pockets and purses.
While eating meals, they try to dispose of food in their napkins or hide it in their pockets.
They cut their meat into very small pieces and spend a great deal of time rearranging thepieces on their plates.
If the patients are confronted with their peculiar behavior, they often deny that their behavior is unusual or flatly refuse to
discuss it. (Kaplan pg 729)
Your Answer. d
Correct Answer. d
(287).
113/119
(288).
All of the following terminologies have been replaced by alternative names in dsm-5 except?
a. Dysthymia
b. Somatoform Disorder
c. Dementia
d. Trichotillomania
Solution. (d) Trichotillomania
Ref:Read the text below
Sol :
(289).
The following person shown in the figure, can maintain this posture for a long period of time. What is the most effective first line
treatment for this patient.
a. Intravenous lorazepam
b. Injectable first generation antipsychotics
c. Oral second generation antipsychotics
d. Electroconvulsive therapy
Solution. (a) Intravenous lorazepam
Ref:Read the text below
Sol :
Sign shown in pic is waxy flexibility; seen in catatonia; first line is iv lorazepam; most effective is ECT.
Your Answer. b
Correct Answer. a
(290).
114/119
(291).
For calling depression as "recurrent", minimum no of episodes required are 2 and these 2 episodes of depression must be
separated by an intervening normal period of at least 2 months.
Your Answer. c
Correct Answer. a
(292).
(293).
115/119
(294).
(295).
(296).
116/119
(297).
(298).
117/119
(299).
(300).
Test Answer
1.(d)
2.(a)
3.(a)
4.(a)
5.(d)
6.(c)
7.(b)
8.(c)
9.(d)
10.(b)
11.(b)
12.(a)
13.(a)
14.(c)
15.(a)
16.(a)
17.(b)
18.(a)
19.(a)
20.(a)
21.(a)
22.(d)
23.(c)
24.(d)
25.(d)
26.(a)
27.(b)
28.(c)
29.(a)
30.(d)
31.(a)
32.(c)
33.(c)
34.(a)
35.(d)
36.(b)
37.(a)
38.(b)
39.(a)
40.(d)
41.(b)
42.(a)
43.(b)
44.(a)
45.(d)
46.(c)
47.(b)
48.(b)
49.(a)
50.(d)
51.(d)
52.(a)
53.(d)
54.(a)
55.(c)
56.(a)
57.(b)
58.(b)
59.(c)
60.(b)
61.(d)
62.(a)
63.(a)
64.(c)
65.(d)
66.(b)
67.(c)
68.(b)
69.(c)
70.(d)
71.(b)
72.(d)
73.(c)
74.(b)
75.(a)
76.(a)
77.(d)
78.(c)
79.(c)
80.(a)
81.(b)
82.(a)
83.(d)
84.(c)
85.(a)
86.(c)
87.(a)
88.(d)
89.(a)
90.(a)
91.(c)
92.(a)
93.(c)
94.(b)
95.(a)
96.(b)
97.(b)
98.(c)
99.(d)
100.(c)
101.(c)
102.(d)
103.(d)
104.(b)
105.(b)
106.(b)
107.(c)
108.(d)
109.(d)
110.(c)
111.(d)
112.(b)
113.(c)
114.(d)
115.(b)
116.(c)
117.(d)
118.(b)
119.(a)
120.(c)
121.(c)
122.(c)
123.(c)
124.(b)
125.(b)
126.(b)
127.(b)
128.(c)
129.(c)
130.(c)
131.(d)
132.(c)
133.(b)
134.(a)
135.(a)
136.(d)
137.(a)
138.(d)
139.(b)
140.(b)
118/119
141.(b)
142.(c)
143.(c)
144.(c)
145.(b)
146.(d)
147.(a)
148.(b)
149.(b)
150.(a)
151.(b)
152.(d)
153.(b)
154.(a)
155.(a)
156.(b)
157.(b)
158.(d)
159.(c)
160.(d)
161.(c)
162.(a)
163.(c)
164.(a)
165.(b)
166.(b)
167.(b)
168.(c)
169.(b)
170.(c)
171.(c)
172.(a)
173.(b)
174.(a)
175.(d)
176.(b)
177.(d)
178.(b)
179.(b)
180.(a)
181.(b)
182.(b)
183.(c)
184.(b)
185.(d)
186.(c)
187.(c)
188.(b)
189.(a)
190.(c)
191.(a)
192.(d)
193.(a)
194.(a)
195.(a)
196.(d)
197.(d)
198.(b)
199.(a)
200.(c)
201.(b)
202.(a)
203.(d)
204.(d)
205.(b)
206.(a)
207.(b)
208.(b)
209.(c)
210.(b)
211.(a)
212.(d)
213.(a)
214.(d)
215.(d)
216.(c)
217.(a)
218.(a)
219.(c)
220.(c)
221.(a)
222.(c)
223.(a)
224.(b)
225.(c)
226.(b)
227.(b)
228.(b)
229.(a)
230.(d)
231.(c)
232.(c)
233.(b)
234.(c)
235.(b)
236.(d)
237.(c)
238.(c)
239.(a)
240.(b)
241.(a)
242.(b)
243.(c)
244.(c)
245.(b)
246.(b)
247.(a)
248.(c)
249.(d)
250.(d)
251.(b)
252.(d)
253.(a)
254.(b)
255.(b)
256.(b)
257.(a)
258.(b)
259.(c)
260.(d)
261.(a)
262.(c)
263.(c)
264.(a)
265.(d)
266.(b)
267.(c)
268.(d)
269.(a)
270.(c)
271.(d)
272.(b)
273.(a)
274.(b)
275.(d)
276.(b)
277.(a)
278.(c)
279.(d)
280.(d)
281.(d)
282.(c)
283.(a)
284.(d)
285.(b)
286.(d)
287.(d)
288.(d)
289.(a)
290.(d)
291.(a)
292.(b)
293.(a)
294.(b)
295.(d)
296.(a)
297.(a)
298.(d)
299.(a)
300.(c)
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